CEREBELLAR MUTISM IN CHILDREN - REPORT OF 6 CASES AND POTENTIAL MECHANISMS

Cerebellar mutism is a rare finding associated with resection of poste rior fossa tumors or cerebellar hemorrhages, We reviewed the medical r ecords of six children, aged 6 to 12 years, who developed cerebellar m utism after resection of a posterior fossa mass or as a result of post erior fossa trauma, From 1989 to 1994, 210 children underwent posterio r fossa resection at our institution, and four developed mutism (an in cidence of 1.6%), All four patients had primitive neuroectodermal tumo rs, The fifth patient experienced trauma, and another patient had an a rteriovenous malformation (AVM). In four children, hydrocephalus devel oped as a result of their tumor or AVM, Four developed cerebellar muti sm 24 to 48 hours after surgery or trauma, and one developed cerebella r mutism 5 days after surgery, coincident with hydrocephalus. In one, mutism occurred after a second resection was performed for a recurrenc e of his posterior fossa tumor, Cerebellar mutism lasted 10 days in on e patient and 2 to 8 weeks in the other four, Dysarthria was apparent in four patients during the recovery phase, We suggest trauma to the d entate nucleus and/or its outflow tract, the superior cerebellar pedun cle, as a cause of reversible mutism, Because posterior fossa tumors a re common in children, mutism should be recognized as an important sid e effect of surgery. (C) 1997 by Elsevier Science Inc.