Pre-operative symptoms

Most cerebellar tumor patients experience classical somatic symptoms such as headaches, nausea and vomiting before surgery. They can also be affected cognitively and emotionally and have problems with language and speech. Ataxia and fine and gross motor problems are common, but patients rarely present with serious neurological signs[2, 3, 4, 5].

Post-operative symptoms

The range of symptoms that children with post-operative pediatric CMS can experience post-operatively is wide, and covers all aspects of the syndrome (linguistic, neuropsychological and neurological/motor problems) [2, 3, 4, 6, 7]. The onset of mutism and neuropsychological symptoms is usually accompanied by new/worsening neurological signs (ataxia, paresis, oculomotor dysfunction, reduced facial expression and incontinence) and marked affective/behavioral abnormalities [3].

Table 1 describes common pre- and post-operative symptoms in children with posterior fossa tumors, based on the old PFS definition (see definitions). The symptomatic spectrume corresponds to the new definition of post-operative pediatric CMS.

Table 1. Common pre- and post-operative symptoms of the PFS (old definition)

Links to:

Definitions, Incidence, Anatomy, Pathophysiology, Imaging findings, Risk factors, Prognosis, Treatment, Prevention

1. Schmahmann, J. D. (2010). The role of the cerebellum in cognition and emotion: personal reflections since 1982 on the dysmetria of thought hypothesis, and its historical evolution from theory to therapy. Neuropsychol Rev 20: 236-260

2. Beckwitt TS, Krieger MD, O'Neil S, Jubran R, Tavare CJ (2012) Symptoms before and after posterior fossa surgery in pediatric patients. Pediatr Neurosurg 48: 21-25

3. Catsman-Berrevoets CE, Aarsen FK (2010) The spectrum of neurobehavioural deficits in the Posterior Fossa Syndrome in children after cerebellar tumour surgery. Cortex 46: 933-946

4. Di Rocco, Chieffo D, Frassanito P, Caldarelli M, Massimi L, Tamburrini G (2011) Heralding cerebellar mutism: evidence for pre-surgical language impairment as primary risk factor in posterior fossa surgery. Cerebellum 10: 551-562

5. Mei C, Morgan AT (2011) Incidence of mutism, dysarthria and dysphagia associated with childhood posterior fossa tumour. Childs Nerv Syst 27: 1129-1136

6. Pollack IF (1997) Posterior fossa syndrome. Int Rev Neurobiol 41: 411-432

7. Turkel SB, Shu CL, Nelson MD, Hyder D, Gilles FH, Woodall L et al (2004) Case series: acute mood symptoms associated with posterior fossa lesions in dhildren. J Neuropsychiatry Clin Neurosc 16: 443-445