{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:14:36Z","timestamp":1787498076208,"version":"build-2736575974"},"reference-count":21,"publisher":"Georg Thieme Verlag KG","issue":"02","license":[{"start":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T00:00:00Z","timestamp":1736726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Asian J Neurosurg"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Cerebellar mutism syndrome (CMS) is a postoperative syndrome of decreased speech seen in children associated with neurobehavioral abnormalities, the incidence of which is up to 40%.<\/jats:p>\n                  <jats:p>To evaluate pediatric patients with posterior fossa tumors for incidence, clinical characteristics, pathophysiology, risk factors, and neuroradiographic features of this syndrome.<\/jats:p>\n                  <jats:p>The study included 60 pediatric patients with a posterior fossa tumor who underwent surgery by a telovelar approach. Detailed pre- and postoperative clinical and radiological evaluations were done. Patients with CMS were analyzed and compared with those without mutism to find risk factors for CMS. The presentation and characteristics of cerebellar mutism were studied along with the following risk factors:<\/jats:p>\n                  <jats:p>The preoperative, immediate postoperative, and 1-year postoperative imaging results were reviewed to assess the neuroradiographic features in the two groups.<\/jats:p>\n                  <jats:p>The incidence of this syndrome was 20%. The mutism was accompanied by some neurobehavioral abnormalities (p-value\u2009=\u20090.05). The most significant finding was the presence of a period of cerebellar dysarthria after the resolution of the muteness (p-value\u2009&lt;\u20090.001) in all cases. Brainstem and related structures' involvement was the most significant risk factor (p-value\u2009=\u20090.03). The presence of brainstem and peduncular edema in the immediate postoperative period (p-value\u2009=\u20090.04) and gross atrophy of posterior fossa structures at 1 year (p-value\u2009=\u20090.01) showed significance toward the development of CMS. There was delayed neurological recovery in patients with CMS with a poor Glasgow Outcome Score at 1 year of follow-up.<\/jats:p>\n                  <jats:p>The clinical presentation of this syndrome in context with neuroradiographic features suggests that it results from transient impairment of the afferent and\/or efferent pathways of dentate nuclei that are involved in initiating complex volitional movements and are associated with brainstem involvement of tumor and poor functional outcome.<\/jats:p>","DOI":"10.1055\/s-0044-1801404","type":"journal-article","created":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T18:53:57Z","timestamp":1736794437000},"page":"260-268","source":"Crossref","is-referenced-by-count":3,"title":["Cerebellar Mutism\/Posterior Fossa Syndrome Following Resection of Posterior Fossa Tumor in Pediatric Patients: Assessing Pathophysiology, Risk Factors, and Neuroradiographic Features"],"prefix":"10.1055","volume":"20","author":[{"given":"Vikrant","family":"Setia","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Geetanjali Medical College and Hospital, Udaipur, Rajasthan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2320-8819","authenticated-orcid":false,"given":"Monirah","family":"Zeya","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, G.B. Pant Institute of Post Graduate Medical Education and Research, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arvind Kumar","family":"Srivastava","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, G.B. Pant Institute of Post Graduate Medical Education and Research, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita","family":"Jagetia","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, G.B. Pant Institute of Post Graduate Medical Education and Research, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,1,13]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.ijrobp.2009.04.058","article-title":"Incidence, risks, and sequelae of posterior fossa syndrome in pediatric medulloblastoma","volume":"77","author":"M P Korah","year":"2010","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.pediatrneurol.2009.01.013","article-title":"Transient mutism and pathologic laughter in the course of cerebellitis","volume":"41","author":"P S Dimova","year":"2009","journal-title":"Pediatr Neurol"},{"key":"ref3","first-page":"444","article-title":"Incidence and severity of postoperative cerebellar mutism syndrome in children with medulloblastoma: a prospective study by the Children's Oncology Group","volume":"105","author":"P L Robertson","year":"2006","journal-title":"J Neurosurg"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1080\/09540260120082155","article-title":"Neurobehavioral abnormalities after posterior fossa surgery in children","volume":"13","author":"I F Pollack","year":"2001","journal-title":"Int Rev Psychiatry"},{"issue":"04","key":"ref5","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1007\/s00381-010-1383-8","article-title":"Cerebellar mutism: incidence, risk factors and prognosis","volume":"27","author":"T Gudrunardottir","year":"2011","journal-title":"Childs Nerv Syst"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"329","DOI":"10.3171\/2009.11.PEDS09131","article-title":"Postoperative cerebellar mutism syndrome following treatment of medulloblastoma: neuroradiographic features and origin","volume":"5","author":"E M Wells","year":"2010","journal-title":"J Neurosurg Pediatr"},{"issue":"05","key":"ref7","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1007\/s007010200067","article-title":"The evaluation and comparison of cerebellar mutism in children and adults after posterior fossa surgery: report of two adult cases and review of the literature","volume":"144","author":"F Ildan","year":"2002","journal-title":"Acta Neurochir (Wien)"},{"issue":"02","key":"ref8","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1002\/pbc.22730","article-title":"Posterior fossa syndrome after posterior fossa surgery in children with brain tumors","volume":"56","author":"S K\u00fcpeli","year":"2011","journal-title":"Pediatr Blood Cancer"},{"issue":"07","key":"ref9","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1016\/j.cortex.2009.10.007","article-title":"The spectrum of neurobehavioural deficits in the posterior fossa syndrome in children after cerebellar tumour surgery","volume":"46","author":"C E Catsman-Berrevoets","year":"2010","journal-title":"Cortex"},{"issue":"02","key":"ref10","first-page":"138","article-title":"Acquired mutism: physiopathy and assessment","volume":"73","author":"L S Turkstra","year":"1992","journal-title":"Arch Phys Med Rehabil"},{"issue":"07","key":"ref11","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1016\/j.cortex.2009.07.018","article-title":"The cerebellum and language: historical perspective and review","volume":"46","author":"B E Murdoch","year":"2010","journal-title":"Cortex"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1093\/brain\/123.5.1051","article-title":"The cerebellum contributes to higher functions during development: evidence from a series of children surgically treated for posterior fossa tumours","volume":"123","author":"D Riva","year":"2000","journal-title":"Brain"},{"issue":"02","key":"ref13","doi-asserted-by":"crossref","first-page":"288","DOI":"10.3174\/ajnr.A1821","article-title":"Cerebellocerebral diaschisis is the likely mechanism of postsurgical posterior fossa syndrome in pediatric patients with midline cerebellar tumors","volume":"31","author":"N G Miller","year":"2010","journal-title":"AJNR Am J Neuroradiol"},{"issue":"06","key":"ref14","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1007\/s00381-011-1460-7","article-title":"Cerebellar mutism: review of the literature","volume":"27","author":"P Frassanito","year":"2011","journal-title":"Childs Nerv Syst"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"1082947","DOI":"10.3389\/fcell.2022.1082947","article-title":"Cerebellar mutism syndrome: from pathophysiology to rehabilitation","volume":"10","author":"F Fabozzi","year":"2022","journal-title":"Front Cell Dev 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Neurosurg"},{"issue":"06","key":"ref19","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1007\/s00381-019-04240-x","article-title":"Cerebellar mutism syndrome: current approaches to minimize risk for CMS","volume":"36","author":"K Cobourn","year":"2020","journal-title":"Childs Nerv Syst"},{"issue":"03","key":"ref20","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1007\/s11060-017-2462-4","article-title":"Analysis of surgical and MRI factors associated with cerebellar mutism","volume":"133","author":"A Sergeant","year":"2017","journal-title":"J Neurooncol"},{"issue":"01","key":"ref21","doi-asserted-by":"crossref","first-page":"35","DOI":"10.3171\/2017.2.PEDS16605","article-title":"Risk factors for development of postoperative cerebellar mutism syndrome in children after medulloblastoma surgery","volume":"20","author":"S YCV Pols","year":"2017","journal-title":"J Neurosurg Pediatr"}],"container-title":["Asian Journal of 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