Tumour type and size are high risk factors for the syndrome of "cerebellar" mutism and subsequent dysarthria.
OBJECTIVE
"Cerebellar mutis" and subsequent dysarthria (MSD) is a documented complication of posterior fossa surgery in children. In this prospective study the following risk factors for MSD were assessed: type, size and site of the tumour; hydrocephalus at presentation and after surgery, cerebellar incision site, postoperative infection, and cerebellar swelling.


METHODS
In a consecutive series of 42 children with a cerebellar tumour, speech and neuroradiological studies (CT and MRI) were systematically analysed preoperatively and postoperatively. Speech was assessed using the Mayo Clinic lists and the severity of dysarthria using the Michigan rating scale.


RESULTS
Twelve children (29%) developed MSD postoperatively. The type of tumour, midline localisation, and vermal incision were significant single independent risk factors. In addition, an interdependency of possible risk factors (tumour>5 cm, medulloblastoma) was found.


CONCLUSIONS
MSD often occurs after paediatric cerebellar tumour removal and is most likely after removal of a medulloblastoma with a maximum lesion diameter>5 cm.
Catsman-Berrevoets
C E
CE
Department of Child Neurology, Sophia Children Hospital, University Hospital Rotterdam, The Netherlands. Catsman@neur.azr.nl
Van Dongen
H R
HR
Mulder
P G
PG
Paz y Geuze
D
D
Paquier
P F
PF
Lequin
M H
MH
D000293:Adolescent; D001254:Astrocytoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D002528:Cerebellar Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D003388:Cranial Fossa, Posterior / Q000601:surgery*; D004401:Dysarthria / Q000175:diagnosis* / Q000209:etiology*; D004806:Ependymoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D018325:Hemangioblastoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008527:Medulloblastoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D009155:Mutism / Q000175:diagnosis / Q000209:etiology*; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013577:Syndrome; D014057:Tomography, X-Ray Computed