title: The anatomical substrate of cerebellar mutism.
abstract: Up to 39% of children operated for a posterior fossa tumor develop the cerebellar mutism syndrome. Although they are alert and cooperative, with normal language comprehension, they are unable to speak. In addition, patients may demonstrate apathy, bladder and bowel incontinence and long-term language and cognitive disturbances. This devastating syndrome is at the same time intriguing, because it confirms a role for the cerebellum in language and cognitive functions. Recent investigations have led to new insights regarding the cerebellar mutism syndrome. The commonly accepted hypothesis states that the mutism is caused by a hypofunction of cerebral hemispheres, due to damage to the superior cerebellar peduncle and functional disruption of the cerebello-cerebral circuitry. This article focuses on the evidence for and against this hypothesis and its clinical consequences.
authors.affiliation: Department of Neurosurgery, Radboud University Medical Hospital, Huispostnummer 636, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands. Electronic address: k.vanbaarsen@nch.umcn.nl.
authors.forename: Kirsten Margaretha
authors.initials: KM
authors.lastname: van Baarsen
authors.affiliation: Department of Neurosurgery, Radboud University Medical Hospital, Huispostnummer 636, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands.
authors.forename: Joachim André
authors.initials: JA
authors.lastname: Grotenhuis
mesh_terms: D002531:Cerebellum / Q000473:pathology*; D002648:Child; D056324:Diffusion Tensor Imaging; D006801:Humans; D015192:Infratentorial Neoplasms / Q000473:pathology / Q000601:surgery*; D009155:Mutism / Q000209:etiology* / Q000473:pathology*; D019635:Neurosurgical Procedures / Q000009:adverse effects*