Cerebellar Mutism Syndrome and Other Complications After Surgery in the Posterior Fossa in Adults: A Prospective Study

TY - JOUR

T1 - Cerebellar Mutism Syndrome and Other Complications After Surgery in the Posterior Fossa in Adults

T2 - A Prospective Study

AU - Wibroe, Morten

AU - Rochat, Per

AU - Juhler, Marianne

N1 - Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

PY - 2018/2

Y1 - 2018/2

N2 - BACKGROUND: Cerebellar mutism syndrome (CMS) is rarely described in adults; however, data on self-assessed linguistic complications after posterior fossa surgery do not exist.METHODS: Through a prospective single-center study, data on 59 tumor operations in the posterior fossa were collected preoperatively as well as 1 week and 1 month postoperatively. Data on self-assessed problems in 5 CMS-related domains, CMS scores, and neurology as well as surgical procedure and complications were obtained.RESULTS: Data on CMS-related complications were obtained on 56 of the 59 operations. None was found to have CMS according to the CMS score. Within each of the 5 domains, at least 9 operations (16%) were followed by development or worsening of self-assessed CMS-related complications. Self-assessed complications were found to be most frequent after primary tumor surgeries, although they were significant only for speech and motor complications (P value = 0.01 and 0.02). Speech and language complications occurred more frequently in midline tumors compared with lateral tumors (40% vs. 7%; P = 0.004). Surgical complications were similar to other studies.CONCLUSIONS: We propose that speech and language problems in adults undergoing surgery in the posterior fossa occur more frequently than previously assumed. Some of the self-assessed complications might reflect components of the cerebellar cognitive affective syndrome. Our findings are consistent with the fact that midline location of the tumor is one of the few known risk factors for CMS in children. Thus, the cerebellar midline seems to be a vulnerable region for speech and language complications also in adults.

AB - BACKGROUND: Cerebellar mutism syndrome (CMS) is rarely described in adults; however, data on self-assessed linguistic complications after posterior fossa surgery do not exist.METHODS: Through a prospective single-center study, data on 59 tumor operations in the posterior fossa were collected preoperatively as well as 1 week and 1 month postoperatively. Data on self-assessed problems in 5 CMS-related domains, CMS scores, and neurology as well as surgical procedure and complications were obtained.RESULTS: Data on CMS-related complications were obtained on 56 of the 59 operations. None was found to have CMS according to the CMS score. Within each of the 5 domains, at least 9 operations (16%) were followed by development or worsening of self-assessed CMS-related complications. Self-assessed complications were found to be most frequent after primary tumor surgeries, although they were significant only for speech and motor complications (P value = 0.01 and 0.02). Speech and language complications occurred more frequently in midline tumors compared with lateral tumors (40% vs. 7%; P = 0.004). Surgical complications were similar to other studies.CONCLUSIONS: We propose that speech and language problems in adults undergoing surgery in the posterior fossa occur more frequently than previously assumed. Some of the self-assessed complications might reflect components of the cerebellar cognitive affective syndrome. Our findings are consistent with the fact that midline location of the tumor is one of the few known risk factors for CMS in children. Thus, the cerebellar midline seems to be a vulnerable region for speech and language complications also in adults.

KW - Brain Neoplasms/surgery

KW - Cerebellar Diseases/etiology

KW - Diagnostic Self Evaluation

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Mutism/etiology

KW - Neurosurgical Procedures

KW - Postoperative Complications

KW - Prospective Studies

KW - Reoperation

KW - Skull Base/surgery

KW - Syndrome

U2 - 10.1016/j.wneu.2017.11.100

DO - 10.1016/j.wneu.2017.11.100

M3 - Journal article

C2 - 29180084

SN - 1878-8750

VL - 110

SP - e738-e746

JO - World Neurosurgery

JF - World Neurosurgery

ER -