Feasibility of cerebello-cortical stimulation for intraoperative neurophysiological monitoring of cerebellar mutism

Giampiccolo, Davide; Basaldella, Federica; Badari, Andrea; Squintani, G.M.; Cattaneo, Luigi; Sala, Francesca Della

doi:10.1016/j.bas.2021.100685

Cited by 1 publication

(1 citation statement)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…At present, IONM is well established for supratentorial functional areas, brainstem and cerebello-pontine angle, but not for monitoring of the cerebellum itself. Recently, the first study was published on IONM of the cerebello-dentato-thalamo-cortical pathway [10]. The authors demonstrated that direct stimulation of lobules IV, V, and VI in the anterior cerebellum and lobule VIIB in the posterior cerebellum leads to inhibition of primary motor cortex excitability for transcranial electrical stimulation.…”

Section: Hypertrophic Olivary Degenerationmentioning

confidence: 99%

Structural damage burden and hypertrophic olivary degeneration in pediatric postoperative cerebellar mutism syndrome

et al. 2022

View full text Add to dashboard Cite

Cerebellar mutism syndrome (CMS) occurs in one out of four children after posterior fossa tumor surgery, with open questions regarding risk factors, pathophysiology, and prevention strategies. Because of similarities between several cerebellar syndromes, a common pathophysiology with damage to the dentato-thalamo-cortical and dentato-rubro-olivary pathways has been proposed. Hypertrophic olivary degeneration (HOD) is an imaging correlate of cerebellar injury observed for instance in stroke patients. Aim of this study was to investigate whether the occurrence and severity of CMS correlates with the extent of damage to the relevant anatomical structures and whether HOD is a time-dependent postoperative neuroimaging correlate of CMS. We performed a retrospective single center study of CMS patients compared with matched non-CMS controls. CMS occurred in 10 children (13% of the overall cohort) with a median age of 8 years. Dentate nucleus (DN) injury significantly correlated with CMS, and superior cerebellar peduncle (SCP) injury was associated by tendency. HOD was observed as a dynamic neuroimaging phenomenon in the postoperative course and its presence significantly correlated with CMS and DN injury. Children who later developed HOD had an earlier onset and tended to have longer persistence of CMS. These findings can guide surgical measures to protect the DN and SCP during posterior fossa tumor resections and to avoid a high damage burden (i.e., bilateral damage). Development of intraoperative neuromonitoring of the cerebellar efferent pathways as well as improved preoperative risk stratification could help to establish a patient-specific strategy with optimal balance between degree of resection and functional integrity.

show abstract

Section: Hypertrophic Olivary Degenerationmentioning

confidence: 99%