What’s Posterior Fossa Syndrome?

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Posterior fossa syndrome is a set of symptoms that can occur after surgical excision of a mass in the brainstem region, affecting children more often. Symptoms include difficulty speaking, swallowing, moving, and eye movement problems. There are no identifiable risk factors, but early recognition can shorten hospital stays.

Posterior fossa syndrome is a set of symptoms that can occur after surgical excision of a mass in the brainstem region. Symptoms generally appear as soon as 24 hours after surgery and can take up to five days to manifest. They can range from mild to quite severe and include aphasia, mutism, difficulty swallowing, mobility problems and eye movement problems. Typically, tumors are more likely to occur in the posterior fossa region of the brain in children.

The posterior fossa region contains the brainstem, which is responsible for controlling breathing, regulating heart rate, dilating and constricting blood vessels, and for a person’s ability to stand for any length of time, as well as walk. Fine muscle movements and the ability to maintain attention on a situation are also vital functions of the brainstem. In a child diagnosed with posterior fossa syndrome, one or more areas of the brain stem have been affected.

A child with this condition will have symptoms of aphasia or difficulty forming words and then vocalizing them. Children can also experience mutism, which is the inability or unwillingness to speak. Difficulty swallowing or dysphagia can be life-threatening and must be addressed immediately. Some children may have difficulty moving one side of their body or have a marked decrease in mobility. Also, cranial nerve palsies can cause strange eye movements and inappropriate gazes.

A family will need to learn how to cope with the physical and mental changes a child with this syndrome is going through. With early recognition of this syndrome, children can start intensive care and shorten the length of hospital stays.

An article published in November 2004 in The Journal of Neuropsychiatry & Clinical Neurosciences focused on the behavioral aspects caused by posterior fossa syndrome. This has been found to be a rather rare condition, affecting only 0.08% of children who have had surgery to the posterior fossa region. Affected children have been found to suffer from mental status changes, such as being withdrawn and apathetic to having full-fledged tantrums.

There are no identifiable risk factors for developing this syndrome. The type of cancer a child has, the exact location and age of the child are not considered factors in determining a child at risk. Surgical excision of a tumor in the posterior fossa region appears to be the only commonality.




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