Posterior Fossa Brain Tissue Injury: Developmental, Neuropsychological, and Neurological Consequences of Brain Tumors in
The aim of the study was the functional neurodevelopmental assessment of children with posterior fossa tumors, specifically examining whether tumor location in particular cerebellar structures determines particular neuropsychological deficits. The examine
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Abstract The aim of the study was the functional neuro developmental assessment of children with posterior fossa tumors, specifically examining whether tumor location in particular cerebellar structures determines particular neuropsychological deficits. The examined group consisted of 34 children treated between 1999 and 2007 at the Division of Pediatric Neurosurgery Silesian University Medical School in Katowice, Poland. Twelve girls and 22 boys between 5 and 21 years of age were examined. The mean age was 12.3 years. There were 21 total and 8 subtotal resections of tumor, and marsupialization was performed in cases of arachnoid cysts. Hydrocephalus in 19 patients was fixed surgically. Histopathological diagnoses of tumors were as follows: 4 medulloblastomas, 8 pilocytic astrocytomas, 6 fibrillary astrocytomas, 1 anaplastic astrocytoma, 2 oligodendrogliomas, 4 anaplastic ependymomas, 1 choroid plexus papilloma, and 5 arachnoid cysts. The children were assessed by age-appropriate tests that examine higher mental functions such as cognitive processes, visual–spatial functions, verbal fluency, planning, sequential memory, and emotions. Additionally, speech examination and tests were performed. The clinical state of all patients was also evaluated, including a full neurological examination. Posterior fossa tumors can disturb normal development of higher mental functions, especially in the development of linguistic and emotional traits. Our study aimed to better understand the functional anatomy of the cerebellum in the context of behavioral changes. Exploration of the consequences of damage to posterior fossa structures may lead to a better understanding of their function in the emotional and cognitive development of children. Moreover, this work may enable the prediction of neurobehavioral disorders and offer appropriate strategies for rehabilitation, qualification, and surgical procedures.
P. Larysz, K. Pietras, and M. Mandera Division of Pediatric Neurosurgery, Medical University of Silesia in Katowice, Ul. Medykow, 16, Katowice 40-752, Poland e-mail: [email protected] S. Blamek Department of Radiotherapy Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branchul Wybrzeże Armii Krajowej, Gliwice 1544-100, Poland
Keywords Higher CNS functions • posterior fossa tumors • cerebellum • children
Background and Purpose CNS tumors appear significantly more frequently in children than in adults and account for 20% of all neoplasms in childhood, making them the second most frequent neoplasm in the pediatric population (18). Furthermore, the tumor location differs between age groups; specifically, supratentorial tumors are more frequent in adults, whereas in children the infratentorial location is more frequent (i.e., posterior fossa tumors). Cerebellar tumors and brainstem tumors account for half of all brain tumors in children (3). However, initial studies on neuropsychological disorders associated with posterior fossa anomalies were performed mainly in adults. These studies charact
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