Skip to main content
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1999 Dec;67(6):755–757. doi: 10.1136/jnnp.67.6.755

Tumour type and size are high risk factors for the syndrome of "cerebellar" mutism and subsequent dysarthria

C Catsman-Berrevoet 1, H R Van Dongen 1, P Mulder 1, G y 1, P Paquier 1, M Lequin 1
PMCID: PMC1736675  PMID: 10567492

Abstract

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.
CONCLUSION—MSD often occurs after paediatric cerebellar tumour removal and is most likely after removal of a medulloblastoma with a maximum lesion diameter>5 cm.



Full Text

The Full Text of this article is available as a PDF (64.4 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aguiar P. H., Plese J. P., Ciquini O., Marino R. Transient mutism following a posterior fossa approach to cerebellar tumors in children: a critical review of the literature. Childs Nerv Syst. 1995 May;11(5):306–310. doi: 10.1007/BF00301766. [DOI] [PubMed] [Google Scholar]
  2. Bak E., van Dongen H. R., Arts W. F. The analysis of acquired dysarthria in childhood. Dev Med Child Neurol. 1983 Feb;25(1):81–87. doi: 10.1111/j.1469-8749.1983.tb13724.x. [DOI] [PubMed] [Google Scholar]
  3. Catsman-Berrevoets C. E., van Dongen H. R., Zwetsloot C. P. Transient loss of speech followed by dysarthria after removal of posterior fossa tumour. Dev Med Child Neurol. 1992 Dec;34(12):1102–1109. doi: 10.1111/j.1469-8749.1992.tb11424.x. [DOI] [PubMed] [Google Scholar]
  4. Crutchfield J. S., Sawaya R., Meyers C. A., Moore B. D., 3rd Postoperative mutism in neurosurgery. Report of two cases. J Neurosurg. 1994 Jul;81(1):115–121. doi: 10.3171/jns.1994.81.1.0115. [DOI] [PubMed] [Google Scholar]
  5. Dailey A. T., McKhann G. M., 2nd, Berger M. S. The pathophysiology of oral pharyngeal apraxia and mutism following posterior fossa tumor resection in children. J Neurosurg. 1995 Sep;83(3):467–475. doi: 10.3171/jns.1995.83.3.0467. [DOI] [PubMed] [Google Scholar]
  6. Darley F. L., Aronson A. E., Brown J. R. Differential diagnostic patterns of dysarthria. J Speech Hear Res. 1969 Jun;12(2):246–269. doi: 10.1044/jshr.1202.246. [DOI] [PubMed] [Google Scholar]
  7. Erşahin Y., Mutluer S., Saydam S., Barçin E. Cerebellar mutism: report of two unusual cases and review of the literature. Clin Neurol Neurosurg. 1997 May;99(2):130–134. [PubMed] [Google Scholar]
  8. Ferrante L., Mastronardi L., Acqui M., Fortuna A. Mutism after posterior fossa surgery in children. Report of three cases. J Neurosurg. 1990 Jun;72(6):959–963. doi: 10.3171/jns.1990.72.6.0959. [DOI] [PubMed] [Google Scholar]
  9. Fraioli B., Guidetti Effects of stereotactic lesions of the dentate nucleus of the cerebellum in man. Appl Neurophysiol. 1975;38(2):81–90. doi: 10.1159/000102647. [DOI] [PubMed] [Google Scholar]
  10. Halperin E. C., Friedman H. S. Is there a correlation between duration of presenting symptoms and stage of medulloblastoma at the time of diagnosis? Cancer. 1996 Aug 15;78(4):874–880. doi: 10.1002/(SICI)1097-0142(19960815)78:4<874::AID-CNCR26>3.0.CO;2-R. [DOI] [PubMed] [Google Scholar]
  11. Kellogg J. X., Piatt J. H., Jr Resection of fourth ventricle tumors without splitting the vermis: the cerebellomedullary fissure approach. Pediatr Neurosurg. 1997 Jul;27(1):28–33. doi: 10.1159/000121221. [DOI] [PubMed] [Google Scholar]
  12. Kulkarni A. V., Becker L. E., Jay V., Armstrong D. C., Drake J. M. Primary cerebellar glioblastomas multiforme in children. Report of four cases. J Neurosurg. 1999 Mar;90(3):546–550. doi: 10.3171/jns.1999.90.3.0546. [DOI] [PubMed] [Google Scholar]
  13. Pencalet P., Maixner W., Sainte-Rose C., Lellouch-Tubiana A., Cinalli G., Zerah M., Pierre-Kahn A., Hoppe-Hirsch E., Bourgeois M., Renier D. Benign cerebellar astrocytomas in children. J Neurosurg. 1999 Feb;90(2):265–273. doi: 10.3171/jns.1999.90.2.0265. [DOI] [PubMed] [Google Scholar]
  14. Pollack I. F., Polinko P., Albright A. L., Towbin R., Fitz C. Mutism and pseudobulbar symptoms after resection of posterior fossa tumors in children: incidence and pathophysiology. Neurosurgery. 1995 Nov;37(5):885–893. doi: 10.1227/00006123-199511000-00006. [DOI] [PubMed] [Google Scholar]
  15. Rekate H. L., Grubb R. L., Aram D. M., Hahn J. F., Ratcheson R. A. Muteness of cerebellar origin. Arch Neurol. 1985 Jul;42(7):697–698. doi: 10.1001/archneur.1985.04060070091023. [DOI] [PubMed] [Google Scholar]
  16. Van Calenbergh F., Van de Laar A., Plets C., Goffin J., Casaer P. Transient cerebellar mutism after posterior fossa surgery in children. Neurosurgery. 1995 Nov;37(5):894–898. doi: 10.1227/00006123-199511000-00007. [DOI] [PubMed] [Google Scholar]
  17. van Dongen H. R., Arts W. F., Yousef-Bak E. Acquired dysarthria in childhood: an analysis of dysarthric features in relation to neurologic deficits. Neurology. 1987 Feb;37(2):296–299. doi: 10.1212/wnl.37.2.296. [DOI] [PubMed] [Google Scholar]
  18. van Dongen H. R., Catsman-Berrevoets C. E., van Mourik M. The syndrome of 'cerebellar' mutism and subsequent dysarthria. Neurology. 1994 Nov;44(11):2040–2046. doi: 10.1212/wnl.44.11.2040. [DOI] [PubMed] [Google Scholar]
  19. van Gijn J., Hijdra A., Wijdicks E. F., Vermeulen M., van Crevel H. Acute hydrocephalus after aneurysmal subarachnoid hemorrhage. J Neurosurg. 1985 Sep;63(3):355–362. doi: 10.3171/jns.1985.63.3.0355. [DOI] [PubMed] [Google Scholar]
  20. van Mourik M., Catsman-Berrevoets C. E., van Dongen H. R., Neville B. G. Complex orofacial movements and the disappearance of cerebellar mutism: report of five cases. Dev Med Child Neurol. 1997 Oct;39(10):686–690. doi: 10.1111/j.1469-8749.1997.tb07364.x. [DOI] [PubMed] [Google Scholar]
  21. van Mourik M., van Dongen H. R., Catsman-Berrevoets C. E. The many faces of acquired neurologic mutism in childhood. Pediatr Neurol. 1996 Nov;15(4):352–357. doi: 10.1016/s0887-8994(96)00226-3. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES