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A paravermal rtans-cerebellar approach to the posterior fossa tumor causes hypertrophic olivary degeneration by dentate nucleus injury

  • 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.

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Author:Martin A. Schaller-PauleORCiDGND, Peter BaumgartenORCiDGND, Volker SeifertORCiD, Marlies WagnerORCiDGND, Eike SteidlORCiDGND, Elke HattingenORCiDGND, Felix Wicke, Joachim Peter SteinbachORCiDGND, Christian FörchORCiDGND, Jürgen KonczallaORCiDGND
URN:urn:nbn:de:hebis:30:3-624803
DOI:https://doi.org/10.3390/cancers13020258
ISSN:2072-6694
Parent Title (English):Cancers
Publisher:MDPI
Place of publication:Basel
Document Type:Article
Language:English
Date of Publication (online):2021/01/12
Date of first Publication:2021/01/12
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2021/09/09
Tag:CMS; HOD; cerebellar mutism; cerebellum; medulloblastoma; neurosurgery
Volume:13
Issue:2, art. 258
Page Number:15
First Page:1
Last Page:15
Note:
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.
HeBIS-PPN:487481526
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Licence (German):License LogoCreative Commons - Namensnennung 4.0