Abstract
PurposeTo report the course of ataxia in children up to 2 years post-operatively, following surgical resection of a posterior fossa tumour (PFT).MethodsThirty-five children, (median age 9 years, range 4–15) having resection of PFT, were assessed using the Scale for the Assessment and Rating of Ataxia (SARA), Brief Ataxia Rating Scale (BARS) and the mobility domain of the Paediatric Evaluation of Disability Index (PEDI-m) at initial post-operative period (baseline), 3 months, 1 year and 2 years post-operatively.ResultsBaseline median scores of the SARA and BARS were 8.5 (range 0–35.5), and 7 (0–25) respectively. Ataxia improved at 3 months (median SARA and BARS reduction 3.5 and 4, respectively). Additional gradual improvements in SARA were recorded at 1 (median reduction 2) and 2 years post-operatively (median reduction 0.5). Median baseline PEDI-m was 54.75 (range 15.2–100) with improvement at 3 months (median increase 36.95) and small improvement at 1 year (median increase 2.5) and 2 years (median increase 5.8). Children with medulloblastoma and midline tumours (median baseline SARA 10 and 11, respectively) demonstrated more severe ataxia than children with low-grade gliomas and unilateral tumours (median baseline SARA 7.5 and 6.5, respectively).ConclusionThe largest improvement in ataxia scores and functional mobility scores is demonstrated within the first 3 months post-operatively, but ongoing gradual improvement is observed at 2 years. Children with medulloblastoma and midline tumour demonstrated higher ataxia scores long term.
Highlights
Posterior fossa tumours (PFT) account for approximately 50% of all childhood brain tumours [1]
We present a new insight into the longitudinal course of ataxia and functional mobility using standardised measures in children with PFT from the peri-operative period, initial post-operative period and up to 2 years post-operatively
Further analysis regarding risk factors for persistent ataxia. This is the largest published longitudinal study to focus on ataxia in children with PFT and the first to report the course of ataxia up to 2 years after surgery including preand post-operative scores
Summary
Posterior fossa tumours (PFT) account for approximately 50% of all childhood brain tumours [1]. More recent reporting with standardised outcome measures has observed approximately 70% [7, 8] of children with PFT which demonstrate balance dysfunction more than 1 year following surgery. Kuper et al [9] presented one of the few studies with longitudinal data, describing the recovery of 12 children with cerebellar tumour from the early post-operative period to reassessment at 3 months and 1 year. They noted ongoing recovery throughout the first year, children with injury to the deep cerebellar nuclei had persistent impairment. We explore the impact of tumour location, histology and adjuvant treatment on severity of ataxia
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
