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Cerebellar mutism: the predictive role of preoperative language evaluation

  • Federico BianchiEmail author
  • Daniela Pia Rosaria Chieffo
  • Paolo Frassanito
  • Concezio Di Rocco
  • Gianpiero Tamburrini
Focus Session

Abstract

Background

The association between preoperative language impairment and development of cerebellar mutism after surgical treatment of posterior fossa tumors has gained increasing interest in recent years based on the concept that both local compression/infiltration of the infratentorial periventricular anatomical structures involved in speech and language, as well as an increased distraction of supratentorial periventricular anatomical structures, due to an associated hydrocephalus, involved in the coordination of speech circuits, might lead to the subclinical presence of language disturbances already at diagnosis, predicting the development of a cerebellar mutism syndrome after tumor removal.

Methods

A thorough review of the literature on the subject has been performed, together with a review of our institutional experience reporting the related long-term (10 years) results.

Results and conclusions

According to our institutional experience, 20/70 (28.5%) children presented preoperative language impairment and developed cerebellar mutism after surgery. A residual impairment persists in 75% of the cases at a follow-up of 2 years, and in 50% of the cases at 10 years, a finding which actually depicts cerebellar mutism no more as a transient deficit but among long-term sequelae. The appearance of complex dysarthria in the postoperative period is a negative prognostic factor for the long-term persistence of speech disturbances.

Keywords

Posterior fossa tumor Medulloblastoma Cerebellar mutism Preoperative language impairment 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Pediatric Neurosurgery, Institute of Neurosurgery and Institute of Infantile NeuropsychiatryFondazione Policlinico Gemelli IRCSSRomeItaly
  2. 2.Università Cattolica del Sacro CuoreRomeItaly
  3. 3.Pediatric NeurosurgeryINIHannoverGermany

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