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Child's Nervous System
Published in: Child's Nervous System 6/2009

01-06-2009 | Original Paper

Brainstem compression: a predictor of postoperative cerebellar mutism

Authors: H. J. McMillan, D. L. Keene, M. A. Matzinger, M. Vassilyadi, M. Nzau, E. C. G. Ventureyra

Published in: Child's Nervous System | Issue 6/2009

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Abstract

Purpose

Cerebellar mutism is a common complication of posterior fossa tumor resection. We observed marked, preoperative brainstem compression on MR imaging, among patients who developed postoperative mutism. This study was designed to investigate if an association was indeed present.

Materials and methods

Patients (18 months–18 years) undergoing resection of a midline, posterior fossa tumor were retrospectively reviewed. Demographic data, tumor pathology, mutism onset and duration, and postoperative complications were obtained from hospital records. Pre- and postoperative MR images were studied to assess tumor size and the severity of pons compression (an estimate of the mechanical and distortional forces imparted by the tumor).

Results

Patients with mutism showed greater preoperative pons compression and a greater increase in postoperative pons diameter.

Conclusion

We predict that brainstem compression may represent white-matter injury from (1) surgical manipulation and traction, and (2) axonal damage caused by the release of the tumor’s compressive force and ensuing axon distortion and dysfunction. The results provide support that mutism may be largely caused by white-matter damage disrupted axon integrity and function.
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Metadata
Title
Brainstem compression: a predictor of postoperative cerebellar mutism
Authors
H. J. McMillan
D. L. Keene
M. A. Matzinger
M. Vassilyadi
M. Nzau
E. C. G. Ventureyra
Publication date
01-06-2009
Publisher
Springer-Verlag
Published in
Child's Nervous System / Issue 6/2009
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-008-0777-3

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