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A CBF decrease in the left supplementary motor areas: New insight into postoperative pediatric cerebellar mutism syndrome using arterial spin labeling perfusion MRI
- Source :
- J Cereb Blood Flow Metab
- Publication Year :
- 2021
- Publisher :
- SAGE Publications, 2021.
-
Abstract
- Postoperative pediatric cerebellar mutism syndrome (pCMS), characterized mainly by delayed onset transient mutism is a poorly understood complication that may occur after pediatric medulloblastoma (MB) resection. Our aim was to investigate postoperative changes in whole-brain cerebral blood flow (CBF) at rest in pCMS patients using arterial spin labeling (ASL) perfusion imaging. This study compared preoperative and postoperative T2-weighted signal abnormalities and CBF using a voxel-wise, whole-brain analysis in 27 children undergoing MB resection, including 11 patients who developed mutism and 16 who did not. Comparison of postoperative T2 signal abnormalities between patients who developed pCMS (mean age 7.0 years) and those who did not showed that pCMS (mean age 8.9 years) patients were significantly more likely to present with T2-weighted hyperintensities in the right dentate nucleus (DN) (p = 0.02). Comparison of preoperative and postoperative CBF in patients with pCMS showed a significant postoperative CBF decrease in the left pre-supplementary motor area (pre-SMA) (p = 0.007) and SMA (p = 0.009). In patients who did not develop pCMS, no significant differences were observed. Findings provide evidence of an association between pCMS, injury to the right DN, and left pre-SMA/SMA hypoperfusion, areas responsible for speech. This supports the relevance of CBF investigations in pCMS.
- Subjects :
- Cerebellar Mutism
Male
medicine.medical_specialty
Adolescent
Mutism
Perfusion Imaging
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Postoperative Complications
Internal medicine
medicine
Humans
Cerebellar Neoplasms
Child
Medulloblastoma
Motor area
business.industry
Delayed onset
Brain
Original Articles
medicine.disease
Perfusion
Neurology
Cerebral blood flow
Cerebrovascular Circulation
Child, Preschool
Arterial spin labeling
Cardiology
Female
Spin Labels
Neurology (clinical)
Cardiology and Cardiovascular Medicine
business
Complication
030217 neurology & neurosurgery
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- J Cereb Blood Flow Metab
- Accession number :
- edsair.doi.dedup.....8b77cadbd03cf6849d0b8dd5935eacf7