An Unusual Postoperative Outcome in Posterior Fossa Surgery: Cerebellar Mutism Syndrome Case Report

Background: Cerebellar mutism is an unusual complication of posterior fossa surgery, particularly within children, whose diagnosis in the postoperative period is delicate. Case Report: A 4-year-old child underwent surgery for a 4th ventricle medulloblastoma. Postoperatively, he developed total mutism with a lack of contact but appropriate reactions to external stimuli. Hypoglossal nerve damage led to persistent swallowing difficulties. Brain MRI showed no compressive elements or residual tumor. After one month, he gradually regained contact, initially with his mother and others. By the second month, he began speaking with dysarthria. Speech therapy led to significant improvement. Conclusion: This case report highlights the importance of early diagnosis of cerebellar mutism to ensure optimal management and improve prognosis. Its exact pathophysiology is still poorly specified in the literature. Postoperative rehabilitation is the cornerstone of treatment, knowing that certain medications have been tested but without great efficiency.