Objective: Radiation therapy (RT) improves rates of survival of patients with childhood brain tumors but increases deficits in cognition and independent living skills. Previous literature has studied difficulties in basic cognitive processes, but few explore impairment in higher-order skills such as adaptive functioning. Some studies identify females as at risk for cognitive deficits due to RT, but few investigate sex differences in adaptive functioning. It was hypothesized that females would exhibit poorer long-term independent living skills and core cognitive skills relative to males following RT. Methods: Forty-five adult survivors of posterior fossa childhood brain tumors (24 females) completed the Wechsler Abbreviated Scale of Intelligence (WASI-II), Wechsler Memory Scale, Third Edition (WMS-III) Digit Span Forward (DSF) and Backward (DSB), and Oral Symbol Digit Modalities Test (OSDMT). Informants completed the Scales of Independent Behavior-Revised (SIB-R). Results: DSF and OSDMT were positively correlated with all five SIB-R domains, full-scale IQ (FSIQ) was positively correlated with four SIB-R domains, and DSB was positively correlated with three SIB-R domains. There was an interaction between sex and RT for OSDMT and community living skills with trend level interactions for personal living skills and broad independent living skills, where females without RT had higher scores than females with RT. Conclusions: Female survivors were more affected by RT than males across the community living skills domain of adaptive functioning as well as processing speed. Processing speed deficits may have a cascading impact on daily living skills. Future studies should investigate how clinical and biological factors may contribute to personalized treatment plans between sexes. (JINS, 2019, 25, 729–739)

Recent evidence argues that the oncogenesis and growth of CNS tumors occurs through dysregulated molecular and cellular mechanisms of neural development. New insights have emerged that have had a significant impact on both research and treatment of these cancers.

We examined short duration perception (400 ms), long duration estimation (30 and 60 min), and spatiotemporal estimation in long-term survivors of childhood cerebellar tumors with a mean time since diagnosis of 14.2 years. Groups of individuals with tumors treated with surgery only (astrocytoma, N = 20) were compared to those with tumors treated with surgery, focal radiation, and craniospinal radiation (medulloblastoma, N = 20), and to age- matched controls (N = 40). Childhood lesions of the cerebellum produced enduring deficits in short-duration perception, but spared the ability to functionally estimate long durations, regardless of the pathology or treatment of the tumor. Evidence did not support any functional recovery over time of the cerebellar system that underlies short-duration perception. Younger age at treatment was not a protective factor. Although no group differences were present in the functional measures of long-duration estimation, tumor-related prospective memory deficits interfered with the ability to produce long-duration prospective estimates. The utilization of sensory and somatomotor information to refine real-world spatiotemporal estimates was compromised in the medulloblastoma group only. (JINS, 2000, 6, 682–692.)

We report a case of a 40-year-old man presenting with acute vertigo and deafness. Computed tomography (CT) scanning at initial presentation was normal. However, one year later he developed numbness on the right side of his face and examination revealed fifth, seventh and eighth cranial nerve palsies as well as cerebellar dysfunction. Magnetic resonance imaging (MRI) demonstrated a cerebellopontine angle lesion. He underwent near total excision followed by neuro-axis irradiation. The main mass of the tumour projected into the cerebellopontine angle. Histology showed this to be a medulloblastoma. All features of this case are unusual; hence we discuss the pathogenesis and management of this very rare tumour.

We report the case of a female patient who presented with sudden deafness as the first symptom of a cerebellar tumour which was not localized strictly in the cerebellopontine angle and did not show direct compression on the extrabulbar portion of the Vlllth cranial nerve. The clinical picture contained a number of signs and symptoms typical of cerebellar involvement.

Surgical intervention restored the hearing and caused the symptoms to disappear.

We also review the association between tumours and sudden deafness in the literature.