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Arterial spin labeling perfusion changes of the frontal lobes in children with posterior fossa syndrome.

Publication ,  Journal Article
Yecies, D; Shpanskaya, K; Jabarkheel, R; Maleki, M; Bruckert, L; Cheshier, SH; Hong, D; Edwards, MSB; Grant, GA; Yeom, KW
Published in: J Neurosurg Pediatr
October 1, 2019

OBJECTIVE: Posterior fossa syndrome (PFS) is a common complication following the resection of posterior fossa tumors in children. The pathophysiology of PFS remains incompletely elucidated; however, the wide-ranging symptoms of PFS suggest the possibility of widespread cortical dysfunction. In this study, the authors utilized arterial spin labeling (ASL), an MR perfusion modality that provides quantitative measurements of cerebral blood flow without the use of intravenous contrast, to assess cortical blood flow in patients with PFS. METHODS: A database of medulloblastoma treated at the authors' institution from 2004 to 2016 was retrospectively reviewed, and 14 patients with PFS were identified. Immediate postoperative ASL for patients with PFS and medulloblastoma patients who did not develop PFS were compared. Additionally, in patients with PFS, ASL following the return of speech was compared with immediate postoperative ASL. RESULTS: On immediate postoperative ASL, patients who subsequently developed PFS had statistically significant decreases in right frontal lobe perfusion and a trend toward decreased perfusion in the left frontal lobe compared with controls. Patients with PFS had statistically significant increases in bilateral frontal lobe perfusion after the resolution of symptoms compared with their immediate postoperative imaging findings. CONCLUSIONS: ASL perfusion imaging identifies decreased frontal lobe blood flow as a strong physiological correlate of PFS that is consistent with the symptomatology of PFS. This is the first study to demonstrate that decreases in frontal lobe perfusion are present in the immediate postoperative period and resolve with the resolution of symptoms, suggesting a physiological explanation for the transient symptoms of PFS.

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Published In

J Neurosurg Pediatr

DOI

EISSN

1933-0715

Publication Date

October 1, 2019

Volume

24

Issue

4

Start / End Page

382 / 388

Location

United States

Related Subject Headings

  • Neurology & Neurosurgery
  • 3213 Paediatrics
  • 3209 Neurosciences
  • 1114 Paediatrics and Reproductive Medicine
 

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Yecies, D., Shpanskaya, K., Jabarkheel, R., Maleki, M., Bruckert, L., Cheshier, S. H., … Yeom, K. W. (2019). Arterial spin labeling perfusion changes of the frontal lobes in children with posterior fossa syndrome. J Neurosurg Pediatr, 24(4), 382–388. https://doi.org/10.3171/2019.5.PEDS18452
Yecies, Derek, Katie Shpanskaya, Rashad Jabarkheel, Maryam Maleki, Lisa Bruckert, Samuel H. Cheshier, David Hong, Michael S. B. Edwards, Gerald A. Grant, and Kristen W. Yeom. “Arterial spin labeling perfusion changes of the frontal lobes in children with posterior fossa syndrome.J Neurosurg Pediatr 24, no. 4 (October 1, 2019): 382–88. https://doi.org/10.3171/2019.5.PEDS18452.
Yecies D, Shpanskaya K, Jabarkheel R, Maleki M, Bruckert L, Cheshier SH, et al. Arterial spin labeling perfusion changes of the frontal lobes in children with posterior fossa syndrome. J Neurosurg Pediatr. 2019 Oct 1;24(4):382–8.
Yecies, Derek, et al. “Arterial spin labeling perfusion changes of the frontal lobes in children with posterior fossa syndrome.J Neurosurg Pediatr, vol. 24, no. 4, Oct. 2019, pp. 382–88. Pubmed, doi:10.3171/2019.5.PEDS18452.
Yecies D, Shpanskaya K, Jabarkheel R, Maleki M, Bruckert L, Cheshier SH, Hong D, Edwards MSB, Grant GA, Yeom KW. Arterial spin labeling perfusion changes of the frontal lobes in children with posterior fossa syndrome. J Neurosurg Pediatr. 2019 Oct 1;24(4):382–388.

Published In

J Neurosurg Pediatr

DOI

EISSN

1933-0715

Publication Date

October 1, 2019

Volume

24

Issue

4

Start / End Page

382 / 388

Location

United States

Related Subject Headings

  • Neurology & Neurosurgery
  • 3213 Paediatrics
  • 3209 Neurosciences
  • 1114 Paediatrics and Reproductive Medicine