Incidence and management of posterior fossa syndrome in children at a tertiary care hospital in Karachi: A 10-year retrospective cohort
Bibliographic record
Abstract
Abstract Background Approximately 60% of pediatric central nervous system (CNS) tumors originate within the posterior fossa. Posterior Fossa Syndrome (PFS), also known as Cerebellar Mutism Syndrome, is a major and sometimes devastating complication of posterior fossa surgery. The incidence of posterior fossa syndrome varies from 10%–48% in reported studies. This study aims to report the incidence and risk factors of PFS along with the role of occupational therapy, speech therapy, and zolpidem in alleviating the symptoms. Methods Patients were included if they were ≤ 18 years old, developed PFS after posterior fossa tumor resection, and were treated between 2014 and 2023 at Aga Khan University Hospital. Data was collected retrospectively by chart review and included symptoms, radiological findings, histopathology, management, and outcomes. Results One hundred and sixty-eight patients with posterior fossa tumors were identified; 116 were males with a median age of 8 years. Tumor location was cerebellar hemisphere in 78 (46.4%) patients, fourth ventricle in 76 (45.2%), cerebellar peduncle in 8 (4.8%), and pons in 6 (3.6%). Medulloblastoma was the most common tumor (37.5%). Of the 168 patients, 63 (37.5%) developed PFS, and the incidence was higher in male patients (P = .001), IVth ventricular tumors (P < .001), and medulloblastomas (P < .001). There was a greater likelihood of improved speech in those treated with speech therapy along with zolpidem (P < .001). Conclusion The incidence of PFS after tumor resection is high in our setting. Patients treated with zolpidem showed significant improvement. The role of this medication should be confirmed in prospective clinical trials.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".