Persistent psychosocial problems in children who develop posterior fossa syndrome after medulloblastoma resection

Posterior fossa syndrome (PFS) occurs in approximately 20% of patients after resection of a tumor from the posterior fossa. Few descriptions of persistent psychosocial consequences exist. We assessed whether the development of PFS is associated with increased risk for emotional, behavioral, and social problems after the cessation of cancer treatment.

Medical charts and neuropsychological data from 21 children (range = 6-17 years old, median = 9.8) were reviewed. All participants were survivors of childhood medulloblastoma and had been treated with surgical resection of the tumor, craniospinal radiation, +/- chemotherapy, and had comprehensive neuropsychological evaluations 1-2 years post-treatment. Six of the 21 were diagnosed with PFS. A series of chi-square tests were conducted to determine whether a relationship existed between PFS and clinically significant levels of emotional, behavioral, and social problems as measured by parent-report on the Achenbach Child Behavior Checklist (CBCL) and Conners' Parent Rating Scale-93 (CPRS-93).

Children who developed PFS were significantly more likely to exhibit obsessive-compulsive type (i.e., perfectionistic) behaviors, withdrawal behaviors, social problems, and internalizing problems (all P < 0.05) than those who did not develop PFS. Additionally, children with PFS were more likely to evidence anxious-shy behaviors, attention problems, and somatic complaints, although these differences were not statistically significant.

Results from the current preliminary study suggest that PFS may place children at increased risk for emotional, behavioral, and social problems long after completion of their cancer treatment.