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In this study, the authors utilized arterial spin labeling (ASL), an MR perfusion modality that provides quantitative measurements of cerebral blood flow without the use of intravenous contrast, to assess cortical blood flow in patients with PFS.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>A database of medulloblastoma treated at the authors\u2019 institution from 2004 to 2016 was retrospectively reviewed, and 14 patients with PFS were identified. Immediate postoperative ASL for patients with PFS and medulloblastoma patients who did not develop PFS were compared. Additionally, in patients with PFS, ASL following the return of speech was compared with immediate postoperative ASL.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>On immediate postoperative ASL, patients who subsequently developed PFS had statistically significant decreases in right frontal lobe perfusion and a trend toward decreased perfusion in the left frontal lobe compared with controls. Patients with PFS had statistically significant increases in bilateral frontal lobe perfusion after the resolution of symptoms compared with their immediate postoperative imaging findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>ASL perfusion imaging identifies decreased frontal lobe blood flow as a strong physiological correlate of PFS that is consistent with the symptomatology of PFS. This is the first study to demonstrate that decreases in frontal lobe perfusion are present in the immediate postoperative period and resolve with the resolution of symptoms, suggesting a physiological explanation for the transient symptoms of PFS.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2019.5.peds18452","type":"journal-article","created":{"date-parts":[[2019,10,4]],"date-time":"2019-10-04T21:54:16Z","timestamp":1570226056000},"page":"382-388","source":"Crossref","is-referenced-by-count":5,"title":["Arterial spin labeling perfusion changes of the frontal lobes in children with posterior fossa syndrome"],"prefix":"10.3171","volume":"24","author":[{"given":"Derek","family":"Yecies","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie","family":"Shpanskaya","sequence":"additional","affiliation":[{"name":"Radiology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashad","family":"Jabarkheel","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Maleki","sequence":"additional","affiliation":[{"name":"Radiology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Bruckert","sequence":"additional","affiliation":[{"name":"Division of Developmental\u2013Behavioral Pediatrics, Stanford University School of Medicine, Stanford, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel H.","family":"Cheshier","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Utah Primary Children\u2019s Hospital, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Hong","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S. 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