![]() Medulloblastoma is a cerebellar-specific posterior fossa tumor which is very frequent in children. Treatment must be done through surgical resection and survival can reach more than 90% in 5 years. The astrocytoma is the most frequent tumor affecting the posterior fossa in children and in 97% of the cases it corresponds to the pilocytic astrocytoma. The main tumors appearing in this zone are medulloblastomas, pilocytic astrocytomas and ependymomas, which together include about 90% of the cases. Posterior fossa tumors constitute two thirds of all pediatric brain tumors. The results are also discussed in the context of the Cerebellar Cognitive Affective Syndrome. The need for differential rehabilitation strategies for specific clinical groups is remarked. Results suggest a differential prefrontal-like deficit due to cerebellar lesions and/or cerebellar-frontal diaschisis, as indicate the results in astrocytoma group (without treatments), that also can be generated and/or increased by treatments in the medulloblastoma group. The resected volume, age at surgery and the time between surgery-evaluation correlated with some neuropsychological executive variables. In the astrocytoma group, the tumor's localization and dentate affectation showed different profile and level of impairment: moderate to slight for vermal and hemispheric patients respectively. ![]() ![]() The Astrocytoma group also showed executive deficits in digits span, semantic fluency (animal category) and moderate to slight deficit in Stroop (word and colour) tests. The Medulloblastoma group showed severe executive deficit (≤ 1.5 SD below normal mean) in all assessed tests, the most severe occurring in vermal patients. The neuropsychological evaluation was made at 3.25 (SD = 2.74) years from surgery in CE group and at 6.47 (SD = 2.77) in CE+ group. Direct scores were corrected by age and transformed in standard scores using normative data. The scores for the non-verbal Raven IQ were also obtained. These tests are very sensitive to dorsolateral PFC and/or to medial frontal cortex functions. The executive functioning was assessed by means of WCST, Complex Rey Figure, Controlled Oral Word Association Test (letter and animal categories), Digits span (WISC-R verbal scale) and Stroop test. Executive variables were correlated with the age at surgery, the time between surgery-evaluation and the resected volume. The performances of the clinical groups with respect to controls were compared considering the tumor's localization (vermis or hemisphere) and the affectation (or not) of the dentate nucleus. Each clinical group was compared in their executive functioning with a paired control group (n = 12). The astrocytoma group (CE, n = 13) did not receive additional treatments. The medulloblastoma group (CE+, n = 7) in addition to surgery received radiation and chemotherapy. This study was realized thanks to the collaboration of children and adolescents who had been resected from cerebellar tumors.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |