Cerebellar mutism in children: report of six cases and potential mechanisms

Pediatr Neurol. 1997 Apr;16(3):218-9. doi: 10.1016/s0887-8994(97)00018-0.

Abstract

Cerebellar mutism is a rare finding associated with resection of posterior fossa tumors or cerebellar hemorrhages. We reviewed the medical records of six children, aged 6 to 12 years, who developed cerebellar mutism after resection of a posterior fossa mass or as a result of posterior fossa trauma. From 1989 to 1994, 210 children underwent posterior fossa resection at our institution, and four developed mutism (an incidence of 1.6%). All four patients had primitive neuroectodermal tumors. The fifth patient experienced trauma, and another patient had an arteriovenous malformation (AVM). In four children, hydrocephalus developed as a result of their tumor or AVM. Four developed cerebellar mutism 24 to 48 hours after surgery or trauma, and one developed cerebellar mutism 5 days after surgery, coincident with hydrocephalus. In one, mutism occurred after a second resection was performed for a recurrence of his posterior fossa tumor. Cerebellar mutism lasted 10 days in one patient and 2 to 8 weeks in the other four. Dysarthria was apparent in four patients during the recovery phase. We suggest trauma to the dentate nucleus and/or its outflow tract, the superior cerebellar peduncle, as a cause of reversible mutism. Because posterior fossa tumors are common in children, mutism should be recognized as an important side effect of surgery.

MeSH terms

  • Brain Concussion / surgery*
  • Cerebellar Neoplasms / surgery*
  • Cerebellum / injuries*
  • Child
  • Cranial Fossa, Posterior
  • Dysarthria / etiology
  • Humans
  • Medical Records
  • Mutism / etiology*
  • Neuroectodermal Tumors, Primitive / surgery*
  • Postoperative Complications*
  • Retrospective Studies