A CBF decrease in the left supplementary motor areas: New insight into postoperative pediatric cerebellar mutism...

Area of Science:

• Neuroscience
• Pediatric Oncology
• Radiology

Background:

• Postoperative pediatric cerebellar mutism syndrome (pCMS) is a poorly understood complication following medulloblastoma (MB) resection.
• Delayed onset transient mutism is a primary characteristic of pCMS.

Purpose of the Study:

• To investigate postoperative changes in whole-brain cerebral blood flow (CBF) using arterial spin labeling (ASL) perfusion imaging in pCMS patients.
• To compare preoperative and postoperative T2-weighted signal abnormalities and CBF in children undergoing MB resection.

Main Methods:

• Voxel-wise, whole-brain analysis of T2-weighted signal abnormalities and CBF.
• Comparison between 11 children who developed pCMS and 16 who did not after MB resection.

Main Results:

• Children with pCMS showed significantly higher likelihood of T2-weighted hyperintensities in the right dentate nucleus (DN).
• pCMS patients exhibited significant postoperative CBF decrease in the left pre-supplementary motor area (pre-SMA) and SMA.
• No significant differences in CBF were observed in patients who did not develop pCMS.

Conclusions:

• Findings suggest an association between pCMS, right DN injury, and hypoperfusion in the left pre-SMA/SMA, areas critical for speech.
• CBF investigations are relevant for understanding and potentially managing pCMS.