MUTISM AFTER SURGICAL REMOVAL OF A CEREBELLAR TUMOR: Two Case Reports

Cataldo, Andrea Di; Dollo, Carmen; Astuto, Marinella; Spina, Milena La; Ippolito, Salvatore; Papotto, Maurizio; Giuffrida, Salvatore

doi:10.1080/088800101300002946

Cited by 17 publications

(8 citation statements)

References 17 publications

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“…A younger age at diagnosis and radiation treatment in children with primitive neuroectoermal cerebellar tumors is associated with poorer outcome (Hoppe-Hirsch et al, 1990; Radcliffe et al, 1994). A form of acquired aphasia, mutism with subsequent dysarthria in which previously acquired language skills are lost (DiCataldo et al, 2001; Dailey et al, 1995; Doxey et al, 1999; Huber-Okrainec et al, 2001; Humphreys, 1989; Rekate et al, 1985; Van Dongen et al, 1994; Van Mourik et al, 1998) has been identified in children, but not in adults, after surgery for posterior fossa tumors. While both childhood and adult cerebellar lesions produce a “cerebellar cognitive affective syndrome” (Schmahmann, 2010), adult cerebellar damage generally results in milder and/or more transient cognitive difficulties (Alexander et al, 2012).…”

Section: The Young Age Plasticity Privilege Has Been Overstatedmentioning

confidence: 99%

Age, plasticity, and homeostasis in childhood brain disorders

Dennis¹,

Spiegler²,

Juranek³

et al. 2013

Neuroscience & Biobehavioral Reviews

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It has been widely accepted that the younger the age and/or immaturity of the organism, the greater the brain plasticity, the young age plasticity privilege. This paper examines the relation of a young age to plasticity, reviewing human pediatric brain disorders, as well as selected animal models, human developmental and adult brain disorder studies. As well, we review developmental and childhood acquired disorders that involve a failure of regulatory homeostasis. Our core arguments are: Plasticity is neutral with respect to outcome. Although the effects of plasticity are often beneficial, the outcome of plasticity may be adaptive or maladaptive.The young age plasticity privilege has been overstated.Plastic change operates in concert with homeostatic mechanisms regulating change at every point in the lifespan.The same mechanisms that propel developmental change expose the immature brain to adverse events, making it more difficult for the immature than for the mature brain to sustain equilibrium between plasticity and homeostasis.Poor outcome in many neurodevelopmental disorders and childhood acquired brain insults is related to disequilibrium between plasticity and homeostasis.

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Section: The Young Age Plasticity Privilege Has Been Overstatedmentioning

confidence: 99%

Age, plasticity, and homeostasis in childhood brain disorders

Dennis¹,

Spiegler²,

Juranek³

et al. 2013

Neuroscience & Biobehavioral Reviews

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“…Some investigators believe that more aggressive surgical technique may determine who develops CMS. Di Cataldo et al [2001] pointed out that CMS had not been reported prior to 1985, and speculated that improvements in imaging and surgical techniques have made neurosurgeons more willing to attempt interventions previously judged impossible. CMS has been shown to occur more often in patients with radical resection than in patients with residual tumors [Van Calenbergh et al, 1995].…”

Section: Cause/mechanism Of Injurymentioning

confidence: 97%

The cerebellar mutism syndrome and its relation to cerebellar cognitive function and the cerebellar cognitive affective disorder

Wells

Walsh

Khademian

et al. 2008

Dev Disabil Res Revs

118

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The postoperative cerebellar mutism syndrome (CMS), consisting of diminished speech output, hypotonia, ataxia, and emotional lability, occurs after surgery in up to 25% of patients with medulloblastoma and occasionally after removal of other posterior fossa tumors. Although the mutism is transient, speech rarely normalizes and the syndrome is associated with long-term adverse neurological, cognitive, and psychological sequelae. The clinical, neuroradiographic, and neuropsychological findings associated with CMS as well as possible mechanisms of injury are reviewed. Theories about the pathophysiology of CMS have evolved along with our understanding of the cerebellum as an important structure in the distributive neurocircuitry underlying complex speech, cognition, and behavior. CMS shares many similarities with the cerebellar cognitive affective syndrome, more commonly described in adults and consisting of disturbances of executive function, visuospatial skills, nonmotor language, and affect regulation. Future directions include more thorough neuropsychological characterization, functional and diffusion tensor imaging studies, and investigations into the underlying differences that may make some patients more vulnerable to CMS.

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“…Its cause is not well understood, though it resolves in several weeks [27]. Mutism may involve damage to the cerebellar vermis, the dentate nucleus [28], or decreased cerebral blood flow to the higher centers secondary to postoperative edema.…”

Section: Mutismmentioning

confidence: 98%

Primitive neuroectodermal tumors/medulloblastoma

M¹

2002

Curr Neurol Neurosci Rep

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The therapy for medulloblastoma/primitive neuroectodermal tumors of the central nervous system is surgery, followed by combination chemo-radiotherapy. The radiation field is the entire craniospinal axis, which is only avoided when treating infants. The treatment is, therefore, lengthy and toxic. Less aggressive therapy is given to patients who clinically appear to have less evidence of disease. Intensive basic research has begun to identify genetic factors of the disease, but these remain far from clinical application.

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MUTISM AFTER SURGICAL REMOVAL OF A CEREBELLAR TUMOR: Two Case Reports

Cited by 17 publications

References 17 publications

Age, plasticity, and homeostasis in childhood brain disorders

Age, plasticity, and homeostasis in childhood brain disorders

The cerebellar mutism syndrome and its relation to cerebellar cognitive function and the cerebellar cognitive affective disorder

Primitive neuroectodermal tumors/medulloblastoma

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