TY  - JOUR
A1  - Schaller-Paule, Martin A.
A1  - Baumgarten, Peter
A1  - Seifert, Volker
A1  - Wagner, Marlies
A1  - Steidl, Eike
A1  - Hattingen, Elke
A1  - Wicke, Felix
A1  - Steinbach, Joachim Peter
A1  - Förch, Christian
A1  - Konczalla, Jürgen
T1  - A paravermal rtans-cerebellar approach to the posterior fossa tumor causes hypertrophic olivary degeneration by dentate nucleus injury
T2  - Cancers
N2  - Posterior fossa tumor surgery is challenging due to the proximity and exposure of cerebellar structures. A favorable operative approach is unknown. Following lesions to the dentato–rubro–olivary-pathway, a neurodegenerative disease called hypertrophic olivary degeneration (HOD) can occur. This study for the first time demonstrates that paravermal trans-cerebellar approaches are associated with a significantly higher likelihood of HOD on MRI when compared to other approaches. This finding can well be attributed to dentate nucleus (DN) injury. Furthermore, cerebellar mutism syndrome (CMS) was discussed in the literature to be correlated with HOD due to a functional overlap of pathways involved. We found no such correlation in this study, but HOD was shown to be a reliable indicator for surgical disruption of efferent cerebellar pathways involving the DN. Henceforth, neurosurgeons should consider more midline or lateral approaches in posterior fossa surgery to spare the DN whenever feasible, and focus on cerebellar functional anatomy in their preoperative planning.
KW  - cerebellum
KW  - cerebellar mutism
KW  - neurosurgery
KW  - HOD
KW  - CMS
KW  - medulloblastoma
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/62480
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-624803
SN  - 2072-6694
N1  - The Dr. Senckenberg Institute of Neurooncology is supported by the Dr. SenckenbergFoundation. E.S. was funded by the Else Kröner-Fresenius Stiftung. There was no funding supporting this specific research project.
VL  - 13
IS  - 2, art. 258
SP  - 1
EP  - 15
PB  - MDPI
CY  - Basel
ER  -