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@ARTICLE{Schmidt:274137,
      author       = {S. Schmidt and E. Kovacs and D. Usta and R. Behnisch and F.
                      Sahm$^*$ and D. Haux and O. Witt and T. Milde and A.
                      Unterberg and A. El Damaty},
      title        = {{C}erebellar mutism syndrome following posterior fossa
                      tumor surgery in children - a retrospective single center
                      study.},
      journal      = {World neurosurgery},
      volume       = {173},
      issn         = {1878-8750},
      address      = {Amsterdam},
      publisher    = {Elsevier},
      reportid     = {DKFZ-2023-00447},
      pages        = {e622-e628},
      year         = {2023},
      note         = {2023 May;173:e622-e628},
      abstract     = {Cerebellar mutism syndrome (CMS) is a well-known
                      complication following posterior fossa tumor surgery in
                      pediatric patients. We evaluated the incidence of CMS in our
                      institute and analyzed association with multiple risk
                      factors, such as tumor entity, surgical approach, and
                      hydrocephalus.All pediatric patients who received an
                      intra-axial tumor resection in the posterior fossa between
                      January 2010 and March 2021 were included for retrospective
                      analysis. Various data points, including demographic,
                      tumor-associated, clinical, radiological, surgery
                      associated, complications and follow-up data were collected
                      and statistically evaluated for association with CMS.63
                      surgeries in 60 patients were included with a median age of
                      8 years. Pilocytic astrocytoma was mostly represented by
                      $50\%,$ followed by medulloblastoma in $28\%,$ and
                      ependymomas in $10\%.$ Complete resection was achieved in
                      $67\%$ versus subtotal in $23\%,$ and partial resection in
                      $10\%.$ Telovelar approach was the most used in 43 $\%$
                      compared to transvermian in $8\%.$ 10 children $(17\%)$
                      developed CMS and showed marked improvement but with
                      residual deficits. Significant risk factors were
                      transvermian approach (p=0.03), vermian splitting whenever
                      added to other approach (p=0.002), initial presentation with
                      acute hydrocephalus (p=0.02), and remaining hydrocephalus
                      after tumor surgery (p=0.004).Our CMS rate compares to those
                      described in literature. Despite the limitations of our
                      study as a retrospective one, we found CMS was not only
                      associated with a transvermian approach, but also occurs
                      after using a telovelar approach, however to a lesser
                      extent. Acute hydrocephalus at initial presentation
                      necessitating urgent management was significantly associated
                      with higher incidence of CMS.},
      cin          = {B300 / HD01},
      ddc          = {610},
      cid          = {I:(DE-He78)B300-20160331 / I:(DE-He78)HD01-20160331},
      pnm          = {312 - Funktionelle und strukturelle Genomforschung
                      (POF4-312)},
      pid          = {G:(DE-HGF)POF4-312},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:36871657},
      doi          = {10.1016/j.wneu.2023.02.117},
      url          = {https://inrepo02.dkfz.de/record/274137},
}