Diffusion abnormalities on intraoperative magnetic resonance imaging as an early predictor for the risk of posterior fossa syndrome

Avula, Shivaram; Kumar, Ram; Pizer, Barry; Pettorini, Benedetta; Abernethy, Laurence; Garlick, Deborah; Mallucci, Conor

doi:10.1093/neuonc/nou299

Cited by 50 publications

(37 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There is growing consensus on the anatomical substrates involved in the causation of POPCMS and interruption of the dentato-thalamo-cortical (DTC) pathway has been attributed to its aetiology (Figure 1) (5)(6)(7). The proximal efferent cerebellar pathway (pECP), which forms the proximal segment of the DTC, has been attributed as the region of primary post surgical insult (8)(9)(10)(11)(12)(13)(14). The pECP mainly constitutes the dentate nucleus (DN), the superior cerebellar peduncle (SCP) and the mesencephalic tegmentum (MT).…”

Section: Original Articlementioning

confidence: 99%

“…These structures are often situated close to the tumour and are prone to damage during surgical resection. Bilateral injury of the pECP has been associated with a greater risk of development of POPCMS (8,10,12,15). Although surgical injury has been attributed to POPCMS, the exact underlying pathophysiology remains unclear and various hypotheses have been proposed (16).…”

Section: Original Articlementioning

confidence: 99%

See 1 more Smart Citation

Post-operative pediatric cerebellar mutism syndrome and its association with hypertrophic olivary degeneration

Avula

Spiteri

Kumar³

et al. 2016

Quant. Imaging Med. Surg.

View full text Add to dashboard Cite

show abstract

Section: Original Articlementioning

confidence: 99%

Section: Original Articlementioning

confidence: 99%

Post-operative pediatric cerebellar mutism syndrome and its association with hypertrophic olivary degeneration

Avula

Spiteri

Kumar³

et al. 2016

Quant. Imaging Med. Surg.

View full text Add to dashboard Cite

show abstract

“…Statistically signifi cant differences in FA values also were found in the frontal lobe and in the superior cerebellar peduncles (Rueckriegel et al 2015 ;Rueckriegel et al 2010 ;Rueckriegel et al 2012b ;Soelva et al 2013 ). Avulam et al identifi ed hypertrophic olivary degeneration as a late imaging marker of CMS, depicting the ruptured Guillain-Mollaret triangle as a critical structure underpinning CMS (Avula et al 2015 ).…”

Section: Posterior Fossa Syndrome/ Cerebellocerebral Diaschisismentioning

confidence: 99%

Female Pelvis: Genital Organs

Forstner

Cunha²

2015

Imaging of Complications and Toxicity Following Tumor Therapy

View full text Add to dashboard Cite

Medical Radiology-Diagnostic Imaging is a unique series that aims to document the most innovative technologies in all fi elds within diagnostic imaging and interventional radiology, thereby informing the physician in practice of the latest advances in diagnostic imaging and percutaneous imageguided minimally invasive procedures. Th e contents are intended to cover all organs, and all modern imaging techniques and image-guided treatment modalities, with special emphasis on applications in clinical practice. Each volume is a comprehensive reference book on a topical theme, and the editors are always experts of high international standing. Contributions are included from both clinicians and researchers, ensuring wide appeal. Medical Radiology -Radiation Oncology is a unique series that aims to document the most innovative technologies in all fi elds within radiology, thereby informing the physician in practice of the latest advances in diagnostic and treatment techniques. Th e contents range from contemporary statements relating to management for various disease sites to explanations of the newest techniques for tumor identifi cation and of mechanisms for the enhancement of radiation eff ects, with the emphasis on maximizing cure and minimizing complications. Each volume is a comprehensive reference book on a topical theme, and the editors are always experts of high international standing. Contributions are included from both clinicians and researchers, ensuring wide appeal. This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. AbstractA precise knowledge of antineoplastic drugs is an indispensable basis for the care of patients with cancer. The mechanisms of action and resistance, cross-resistance patterns, pharmacodynamics and pharmacokinetics, pharmacological interaction, and last but not least potential adverse effects should be part of this knowledge. As contemporary cancer care requires interdisciplinary and multiprofessional structures, the radiologist is an important a...

show abstract

“…Several hypotheses have been proposed for the etiology of PFS including vasospasm, edema, transient disruption in release of neurotransmitter, or transient changes in autoregulation due to thermal injury . Factors that may contribute to PFS include permanent white matter changes due to direct damage from surgical resection, axonal injury, or inflammatory response …”

Section: Introductionmentioning

confidence: 99%

“…[6][7][8] Factors that may contribute to PFS include permanent white matter changes due to direct damage from surgical resection, axonal injury, or inflammatory response. 4,9 A number of preoperative conventional radiographic findings, such as location and size of the tumor, have been associated with development of PFS, but not in a consistent manner. 10,11 Previous work has demonstrated that bilateral injuries to the proximal dentatothalamocortical pathways appear to predispose patients to the development of PFS.…”

Section: Introductionmentioning

confidence: 99%

Diffusion Tensor Imaging Connectomics Reveals Preoperative Neural Connectivity Changes in Children with Postsurgical Posterior Fossa Syndrome

Meoded

Jacobson

Liu

et al. 2020

Journal of Neuroimaging

View full text Add to dashboard Cite

BACKGROUND AND PURPOSE Posterior fossa syndrome (PFS), characterized by loss of language and other neurological impairments within the immediate postoperative period, occurs in approximately 25% of children who undergo surgical resection of posterior fossa tumors. Diffusion tensor imaging connectomics offer promise for elucidation of pathway‐level disruption in neural connectivity of patients with this disorder. We aim to determine differences in pre‐ and postoperative connectomics between children with PFS and children with mild or no language deficit after surgery. METHODS Pre‐ and postoperative diffusion tensor imaging connectomics were applied and compared among patients with PFS, mild deficits, and intact language. RESULTS A total of 35 patients were included in the study. Twenty‐three patients with preoperative data and 24 patients with postoperative data were included in the analysis. Mean ages: PFS—8.5 years, mild–3.1 years, intact language—9.4 years (P = .02). Diagnoses included medulloblastoma (44.1%), pilocytic astrocytoma (28.6%), ependymoma (8.6%), other (11.4%), and unknown (8.6%). Five (21.7%) patients had PFS, 4 (17.4%) had mild deficits, and 14 (60.9%) had intact language. The assortativity coefficient was significantly higher in patients with PFS when compared to patients with mild deficits (P = .023). In the connectometry analyses, decreased connectivity was found involving the corpus callosum, right corticothalamic pathway, and right corticostriatal pathway in patients with PFS when compared to patients with intact language. CONCLUSIONS Our findings revealed significant differences in preoperative neural connectivity involving the corticothalamic and other pathways among children who did, versus who did not, develop PFS postoperatively. Diffusion tensor imaging connectomics offers a unique opportunity to study the effect of the posterior fossa tumors on cerebello‐cerebral networks and provide new insights into the mechanism of the structural plasticity/reorganization after surgery.

show abstract

Diffusion abnormalities on intraoperative magnetic resonance imaging as an early predictor for the risk of posterior fossa syndrome

Abstract: This study demonstrates the feasibility of identifying children at risk for developing PFS at the earliest stage post tumor resection and thus adds to the growing evidence base on its pathophysiology.

Cited by 50 publications

References 28 publications

Post-operative pediatric cerebellar mutism syndrome and its association with hypertrophic olivary degeneration

Post-operative pediatric cerebellar mutism syndrome and its association with hypertrophic olivary degeneration

Female Pelvis: Genital Organs

Diffusion Tensor Imaging Connectomics Reveals Preoperative Neural Connectivity Changes in Children with Postsurgical Posterior Fossa Syndrome

Contact Info

Product

Resources

About