title: Neurobehavioral and neurologic outcome in long-term survivors of posterior fossa brain tumors: role of age and perioperative factors.
abstract: We evaluated the neuropsychological and neurologic outcome of 15 long-term survivors of posterior fossa tumors who were treated between 1970 and 1984 with cranial irradiation (n = 15) and surgery (n = 14). The interval between diagnosis and evaluation ranged from 4 to 20 years (median = 10 years). Earlier age at diagnosis (< 6 years) was associated with an increased incidence of severe neurologic and neuropsychological sequelae. Hydrocephalus, obtundation, and tumor extension outside the vermis also were more prevalent in the younger group. Poor neurobehavioral outcomes in young children with posterior fossa tumors may be related to more aggressive tumor growth or complications of the initial therapy and not solely due to toxicity from craniospinal irradiation.
authors.affiliation: Department of Neurology, Children's Hospital, Boston, MA 02115, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Chapman
authors.forename: D P
authors.initials: DP
authors.lastname: Waber
authors.forename: J H
authors.initials: JH
authors.lastname: Bernstein
authors.forename: S L
authors.initials: SL
authors.lastname: Pomeroy
authors.forename: B
authors.initials: B
authors.lastname: LaVally
authors.forename: S E
authors.initials: SE
authors.lastname: Sallan
authors.forename: N
authors.initials: N
authors.lastname: Tarbell
mesh_terms: D000293:Adolescent; D000328:Adult; D001921:Brain / Q000503:physiopathology / Q000528:radiation effects; D001925:Brain Damage, Chronic / Q000209:etiology / Q000503:physiopathology; D002528:Cerebellar Neoplasms / Q000503:physiopathology / Q000532:radiotherapy* / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003388:Cranial Fossa, Posterior; D016371:Cranial Irradiation; D003399:Craniotomy; D004806:Ependymoma / Q000503:physiopathology / Q000532:radiotherapy* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008527:Medulloblastoma / Q000503:physiopathology / Q000532:radiotherapy* / Q000601:surgery*; D009460:Neurologic Examination / Q000187:drug effects / Q000528:radiation effects; D009483:Neuropsychological Tests; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology; D011832:Radiation Injuries / Q000209:etiology / Q000503:physiopathology; D016896:Treatment Outcome