gms | German Medical Science

60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit den Benelux-Ländern und Bulgarien

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

24. - 27.05.2009, Münster

Fronto-cerebellar tractography in patients following cerebellar tumor removal – correlation with posterior fossa syndrom

Meeting Abstract

  • V. Soelva - Selbständiger Arbeitsbereich Pädiatrische Neurochirurgie, Charité - Universitätsmedizin Berlin
  • A. Abbushi - Klinik für Neurochirurgie, Charité - Universitätsmedizin Berlin
  • S. Rueckriegel - Klinik für Kinderhämatologie und -onkologie, Charité - Universitätsmedizin Berlin
  • P. Hernaiz - Klinik für Kinderhämatologie und -onkologie, Charité - Universitätsmedizin Berlin
  • H. Bruhn - Radiologie, Charité - Universitätsmedizin Berlin
  • H. Haberl - Selbständiger Arbeitsbereich Pädiatrische Neurochirurgie, Charité - Universitätsmedizin Berlin
  • U.W. Thomale - Selbständiger Arbeitsbereich Pädiatrische Neurochirurgie, Charité - Universitätsmedizin Berlin

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocMO.08-05

DOI: 10.3205/09dgnc048, URN: urn:nbn:de:0183-09dgnc0486

Veröffentlicht: 20. Mai 2009

© 2009 Soelva et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Cerebellar mutism syndrome (CMS) is a dreaded complication following fossa posterior tumor removal in children and is characterized by an inhibition of neuropsychological impulsion. Similar symptoms can also be observed after extensive bifrontal lobe disturbances. We hypothesize that disruption of fronto-cerebellar association fibres (FCF) may be involved to cause the manifestation of this syndrome.

Methods: In 29 patients (mean age: 8.9±4.4 years), who received posterior fossa tumor removal (pilocytic astrocytoma [n=14], medulloblastoma [n=13], ependymoma [n=2]) as well as in 10 healthy children (12.9±3.8 years), diffusion weighted imaging (3Tesla MRI, Signa, GE) was performed to generate tractography of FCF using a fiber tracking algorithm software (brainLab 2.5). The volume of these fibre tracts was measured in each patient. On reconstructed slices the anatomical course of the fibres were determined and measured in a semiquantitative manner. In addition postoperative clinical symptoms of CMS were recorded.

Results: The pathway of FCF could be visualized bilaterally in each patient. In volume measurements of FCF a significant difference between children with symptoms of CMS (19.3±11.7 cm3) could be observed compared to neurological unaffected children (26.9±11.9 cm3) and to control group (36.5±13.82 cm3). In the semi-quantitative analysis of anatomical structures significant differences of the fibre tract visualization was observed in the superior cerebellar peduncle and the midline cerebellar structures comparing CMS with less distinct tracts compared to neurological unaffected children as well as compared to controls (p<0.01). Similar differences were found in the same structures looking at medulloblastoma compared to pilocytic astrocytoma patients as well as the control group (p<0.05).

Conclusions: DTI is a feasible method for visualizing fronto-cerebellar fiberes. Our data identifies the involvement of postoperative disturbed FCF tracts at the location of the superior cerebellar peduncle and midline cerebellar structures to contribute to CMS.