Anatomical underpinnings of a postoperative syndrome following pediatric cerebellar tumor resection
Cerebellar Mutism Syndrom (CMS) is a debilitating postoperative complication affecting approximately 25% of children who undergo posterior fossa tumor resection. CMS is characterized by mutism, emotional lability, and executive dysfunction. Prior work from our group identified damage to the cerebellar outflow pathway as a key anatomical risk factor. This project attempted to replicate these findings in an independent cohort and whether lesion location could reliably stratify surgical risk.
Pediatric patients from two sites who underwent posterior fossa tumor resection were included and tumor resection cavities were mapped. THese lesion masks were overlapped with the cerebellar outflow pathway and the extent of overlap was compared between CMS+ and CMS- patients. A lesion map derived from our group's prior cohort was also tested.
CMS+ patients showed significantly greater lesion overlap with the cerebellar outflow pathway compared to CMS- patients, and significantly greater overlap with the previously derived lesion map. These results replicate and extend prior findings, reinforcing the cerebellar outflowpathway as a reliable anatomical risk factor across independent cohorts.
Published in Brain Communications (2024), Vol. 6(4).