Abstract
Cerebellar mutism is one of the complications of posterior fossa surgery for the midline mass lesions. We report a case of 4-year-old boy who was performed the surgical resection of astrocytoma located in the fourth ventricle. Preoperatively, he presented with headache and vomiting, which had worsened during a week prior to the admission. Neurological examination revealed papilledema and nystagmus. Computed tomographic scan revealed a vermian tumor filling the fourth ventricle. On the 2 nd postoperative day, he developed mutism with the poor oral intake and emotional lability. His speech began to recover with dysarthria 6 weeks later. In the previous reports cerebellar nutism developed frequently after the resection of the posterior fossa tumors such as medulloblastoma in the vermis. It is conceivable that preoperative intracranial hypertension is a factor of developing cerebellar mutism. Additionaly, developing cerebellar mutism might be associated with the edema and ischema of cerebellar hemisphere caused by the retraction of the cerebellum at the surgery.
