Posterior fossa syndrome is a collection of symptoms that can occur following surgical excision of a mass in the brain stem region. The symptoms generally occur as soon as 24 hours following surgery and can take as long as five days to appear. They can range from mild to rather severe, and include aphasia, mutism, difficulty swallowing, mobility problems, and eye movement issues. 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 giving a person the ability to stand for a period of time, as well as walk. Fine muscle movements and the ability to maintain attention to a situation are also vital functions of the brainstem. In a child diagnosed with posterior fossa syndrome, one or more areas of the brainstem have been affected.
A child with this condition will present with 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 needs to be addressed immediately. Some children may experience difficulty moving one side of their bodies or have a marked decrease in mobility. In addition, cranial nerve palsies can cause strange eye movements and fixed gazes that are not appropriate.
A family will need to learn how to deal with the physical and mental changes that a child with this syndrome is going through. With early recognition of this syndrome, children can begin intensive therapy and decrease 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. It was found that this is a rather rare condition, affecting only 0.08% of children who have undergone surgery to the posterior fossa region. Affected children were found to suffer from mental status changes, such as being withdrawn and apathetic to having full-fledged tantrums.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 tumor a child has, the exact location, and the child’s age are not considered to be factors in determining a child who is at risk. Surgical excision of a tumor in the posterior fossa region seems to be the only commonality.