Posterior fossa syndrome linked to lasting neurocognitive challenges in childhood medulloblastoma survivors

Children who develop posterior fossa syndrome after surgery for medulloblastoma may experience lasting neurocognitive and physical challenges. Posterior fossa syndrome is a debilitating postoperative complication characterized by reduced or absent speech, loss of muscle tone, and emotional lability. Although acute symptoms often improve within the first year after surgery, the long-term trajectory of these impairments has remained unclear.

A long-term study of survivors of childhood medulloblastoma led by Supriya Sarvode, MD, Division of Neuro-Oncology, and Nicholas Phillips, MD, PhD, Department of Psychology & Biobehavioral Sciences, found that survivors who developed posterior fossa syndrome had poorer attention, processing speed, executive function and physical performance decades after treatment compared with survivors who did not develop the syndrome. Survivors with posterior fossa syndrome were also significantly more likely to require assistance with routine daily activities, underscoring the lasting impact of this complication on independence and quality of life. The study highlights the need for early intervention and long-term monitoring to support neurocognitive health in this high-risk population. The study was published in JAMA Network Open.

“We suspected that children with posterior fossa syndrome might face long-term neurocognitive challenges, but the magnitude of the impact was striking,” Phillips said. “They were eight times more likely to need help with everyday activities and twice as likely to have physical impairments that affect daily life. As these survivors reach adulthood, these challenges can limit independence and significantly affect quality of life.”

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