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Abstract
The Cerebellar Mutism Syndrome (CMS) is a severe complication after resection of a pediatric cerebellar tumor. Incidence rates vary and sophisticated neurocognitive and academic outcome studies are still rare. CMS is characterized by entire absence of speech for a certain time period after surgery. However, during long-term follow-up other distinct neurocognitive deficits become apparent, which have the impact to severely influence everyday life and academic achievement. Hence, the aim of this study was to investigate the long-term impact of cerebellar tumor treatment with a special focus on CMS. Therefore we retrospectively analyzed a consecutive sample of n=105 pediatric cerebellar tumor patients, all treated at the Medical University of Vienna between 2001 and 2015. Most common histologies were pilocytic astrocytoma (45.7%), medulloblastoma (31.4%) and ependymoma (13.3%). Eight patients were diagnosed with CMS (incidence rate = 7.6%). All patients underwent a comprehensive standard-of-care neuropsychological test-battery. Median time between diagnosis and follow-up assessment was 4 years. All patients suffering from postoperative CMS needed a special form of academic/occupational support at the time of assessment, compared to only 33% in the total sample. Regarding neurocognitive functioning, CMS patients showed significantly lower results in certain cognitive domains (e.g. divided attention, information processing speed). In conclusion, patients with CMS turned out to be a high-risk-group regarding neurocognitive late-effects, which in turn affect academic achievement and the need for special support services. Moreover, the results indicate the need for deficit-specific neurocognitive therapy and counselling. for pediatric cerebellar tumor patients in order to overcome illness-related academic disadvantages.