Cause and outcome of cerebellar mutism: evidence from a systematic review.
OBJECTIVE
Cerebellar mutism is a serious neurosurgical complication after posterior fossa surgery, but the cause, incidence and outcome remain incompletely defined. The aim of this paper was to identify and review all reports of this phenomenon to better delineate and improve the evidence base.


METHODS
A systematic search and retrieval of databases was conducted using advanced search techniques. Review/outcomes criteria were developed, and study quality was determined.


RESULTS
The retrieval identified 2,281 papers of which 96 were relevant, identifying 650 children with cerebellar mutism. Causative factors, clinical features and outcomes were reported variably; papers focussed on multiple areas, the majority reporting incidence in single or series of case studies with little or no analysis further than description.


CONCLUSIONS
The complexity and variability of data reporting, likely contributing factors and outcomes make cerebellar mutism difficult to predict in incidence and the degree of impact that may ensue. A clear and accepted universal definition would help improve reporting, as would the application of agreed outcome measures. Clear and consistent reporting of surgical technique remains absent. Recommendations for practice are provided.
Paediatric Neuropsychology, The Leeds Teaching Hospitals NHS Trust, Leeds General Infirmary, Great George Street, Leeds, LS1 3EX, UK.
Rosa
R
Reed-Berendt
Bob
B
Phillips
Susan
S
Picton
Paul
P
Chumas
Daniel
D
Warren
John H
JH
Livingston
Ellen
E
Hughes
Matthew C H J
MC
Morrall
D000293:Adolescent; D002526:Cerebellar Diseases / Q000150:complications* / Q000523:psychology / Q000601:surgery / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003071:Cognition / Q000502:physiology; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009155:Mutism / Q000209:etiology* / Q000523:psychology / Q000601:surgery / Q000628:therapy*; D019635:Neurosurgical Procedures; D017594:Publication Bias; D012307:Risk Factors; D016896:Treatment Outcome