ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2020
Cerebellar mutism syndrome: current approaches to minimize risk for CMS.
Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 citations in OpenAlex.
- Pre-operative and intra-operative risk factors of post-operative cerebellar mutism syndrome in pediatric patients undergoing posterior fossa tumor surgery: a systematic review.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Pooled it
- Neurosurgical practice and its influence on postoperative paediatric cerebellar mutism syndrome-the Alder Hey experience.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Article
- Does the surgical route matter in cerebellar mutism syndrome? Comparing transvermian and telovelar approaches for pediatric posterior fossa tumors.Brain & spine · 2026Review
- Association between perioperative factors and the occurrence of postoperative cerebellar mutism syndrome in children.Frontiers in neurology · 2026Article
- Cerebellar Mutism/Posterior Fossa Syndrome Following Resection of Posterior Fossa Tumor in Pediatric Patients: Assessing Pathophysiology, Risk Factors, and Neuroradiographic Features.Asian journal of neurosurgery · 2025Article
- Postoperative word-finding difficulties in children with posterior fossa tumours: a crosslinguistic European cohort study.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2025Article
- Sex as an independent risk factor for cerebellar mutism syndrome: a validation study.Frontiers in surgery · 2025Article
- Cerebellar Mutism Syndrome in a Patient With Hypertensive Urgency and Ischemia: A Case Report.Cureus · 2024Article
- Surgery for pediatric low-grade gliomas within the vermis.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2024Review
- Proceedings of the first global meeting of the Posterior Fossa Society: state of the art in cerebellar mutism syndrome.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2024Article
- Postoperative cerebellar mutism syndrome is an acquired autism-like network disturbance.Neuro-oncology · 2024Article
- Evolution of neurosurgical advances and nuances in medulloblastoma therapy.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2024Review
- Application of the Rotterdam postoperative cerebellar mutism syndrome prediction model in patients undergoing surgery for medulloblastoma in a single institution.Journal of neurosurgery. Pediatrics · 2024Article
- Medulloblastomas, CNS embryonal tumors, and cerebellar mutism syndrome: advances in care and future directions.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2023Review
- Cerebellar mutism syndrome of non-tumour surgical aetiology-a case report and literature review.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2023Review
- Fastigial nuclei surgical damage and focal midbrain disruption implicate PAG survival circuits in cerebellar mutism syndrome.Neuro-oncology · 2023Article
- Occipital interhemispheric transtentorial approach in pediatric patients for lesions of the superomedial cerebellum: operative findings and results.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2023Article
- The Cerebellar Mutism Syndrome: Risk Assessment, Prevention and Treatment.Advances and technical standards in neurosurgery · 2023Article
- Telovelar versus transvermian approach to tumors of the fourth ventricle and their impact on postoperative neurological complications: A multicenter study.Surgical neurology international · 2023Article
- The Entity of Cerebellar Mutism Syndrome: A Narrative Review Centered on the Etiology, Diagnostics, Prevention, and Therapeutic Options.Children (Basel, Switzerland) · 2022Review
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeCerebellar mutism syndrome (CMS) is a serious source of morbidity following posterior fossa surgery in the pediatric population. However, methods for effectively decreasing its incidence and impact remain unclear. It is our aim to examine the impact of adjusting surgical factors, namely the use of a telovelar approach and avoidance of cavitronic ultrasonic aspirator, on the incidence of CMS in our population as well as outlining potential pre-, intra-, and postoperative factors that may contribute to its development.
methodsRetrospective review was performed to identify patients undergoing posterior fossa surgery for resection of a medulloblastoma. Demographic, surgical, and postoperative data were collected. These data were analyzed for possible correlations to the risk of developing CMS via univariate analysis. For factors found to be significant, a multivariate analysis was performed to assess their independence.
resultsSeven of 65 patients (10.8%) developed CMS postoperatively. Factors found to be significantly associated with a higher risk of CMS were the degree of retraction utilized during the procedure (p = 0.0000) and incision of the vermis (p = 0.0294). Although they did not reach the threshold of statistical significance, tumor vascularity (p = 0.19), adoption of a transvermian approach (p = 0.19), and lack of intraoperative imaging (p = 0.17) exhibited strongly suggestive trends towards a correlation with CMS. DISCUSSION: In an effort to reduce the incidence and severity of CMS in our population, our institution adopted surgical practices that minimize tissue trauma and mitigate postoperative edema. This included the use of a telovelar over a transvermian approach to obviate the need for vermian incision, avoidance of the CUSA, and minimization of heavy retraction during surgery. This was successful in reducing the incidence of CMS from 39% in our medulloblastoma patients to 10.8%. The development of CMS after posterior fossa surgery appears to be a "two-hit" phenomenon requiring a combination of existing predisposition, surgical injury, and postoperative exacerbation. Therefore, it is critical to identify the factors involved at each stage and investigate treatments to target them appropriately.
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