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失语症、忽视症和消退现象在患有急性外科小脑病变的儿童和青少年中并非显著的临床症状。

Aphasia, neglect and extinction are no prominent clinical signs in children and adolescents with acute surgical cerebellar lesions.

作者信息

Frank Benedikt, Schoch Beate, Hein-Kropp Christoph, Hövel Matthias, Gizewski Elke Ruth, Karnath Hans-Otto, Timmann Dagmar

机构信息

Department of Neurology, University of Duisburg-Essen, Hufelandstr. 55, 45122 Essen, Germany.

出版信息

Exp Brain Res. 2008 Feb;184(4):511-9. doi: 10.1007/s00221-007-1116-8. Epub 2007 Sep 9.

Abstract

The aim of the present study was to examine if clinically significant signs of aphasia, neglect or extinction, which have a well-known cerebral lateralization, are present in children and adolescents with acute focal lesions following tumour surgery in the cerebellum. Eight children and adolescents with cerebellar tumours were tested within days after tumour surgery. None of the children had received radiation or chemotherapy at the time of testing. Eleven age- and education-matched control subjects with major orthopedic surgery participated. High-resolution magnetic resonance images showed lesions of the right cerebellar hemisphere in three and of the left hemisphere in five children. Standard aphasia tests revealed no statistically significant difference comparing children with right- and left-sided lesions and controls. Mild signs of language disturbance, however, were present in single subjects with right-sided cerebellar lesions. Neglect and extinction tasks revealed minor abnormalities, which lacked consistent lateralization and were best explained by more unspecific attentional deficits and motor disorders in acute post-surgical stage. Acute right-sided cerebellar lesions can be followed by mild signs of language disturbances in single subjects. Clinically significant signs of neglect and extinction, however, are not observed in children and adolescents with acute surgical cerebellar lesions.

摘要

本研究的目的是检查患有急性局灶性病变的儿童和青少年在小脑肿瘤手术后是否存在失语、忽视或消退等具有明确脑侧化的临床显著体征。八名患有小脑肿瘤的儿童和青少年在肿瘤手术后数天内接受了测试。测试时,没有一名儿童接受过放疗或化疗。十一名年龄和教育程度匹配的接受重大骨科手术的对照受试者参与了研究。高分辨率磁共振成像显示,三名儿童右侧小脑半球有病变,五名儿童左侧小脑半球有病变。标准失语测试显示,右侧和左侧病变儿童与对照之间没有统计学上的显著差异。然而,右侧小脑病变的个别受试者存在轻度语言障碍迹象。忽视和消退任务显示有轻微异常,这些异常缺乏一致的侧化,最好用急性术后阶段更非特异性的注意力缺陷和运动障碍来解释。急性右侧小脑病变可能会在个别受试者中出现轻度语言障碍迹象。然而,患有急性手术性小脑病变的儿童和青少年未观察到临床上显著的忽视和消退体征。

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