Kotil Kadir, Eras Mustafa, Akçetin Mustafa, Bilge Turgay
Haseki Educational and Research Hospital, Neurosurgery Department Istanbul, Turkey.
Turk Neurosurg. 2008 Jan;18(1):89-94.
Cerebellar mutism is a documented complication of posterior fossa surgery in pediatric ages. Risk factors such as the type of tumor, size, and location of tumor, hyrdrocephalus, postoperative cerebellar swelling for cerebellar mutism were investigated in this study.
A consecutive series of 32 children with a cerebellar tumor were operated on at the Haseki Educational and Research Hospital, Department of Neurosurgery, between 1990 and 2005. Their speech and neuroradiological studies were systematically analysed both preoperatively and postoperatively
Cerebellar mutism developed in ten children (32%) in the early postoperative period. The type of tumor, midline localization, and vermian incision were significant single independent risk factors. In addition, an interdependency of possible risk factors (tumor > 5 cm, medulloblastoma) was found. The latency for the development of mutism ranged from 0 to 90 days (mean 15.6 d). The speech returned to normal in eight patients. All cases were accompanied by cerebellar ataxia.
Mutism after posterior fossa tumor resection is also associated with ataxia. Cerebellar mutism usually has a self-limiting course and a favorable prognosis.
小脑缄默症是小儿后颅窝手术中一种已被证实的并发症。本研究调查了诸如肿瘤类型、大小、位置、脑积水、术后小脑肿胀等小脑缄默症的危险因素。
1990年至2005年间，在哈塞基教育与研究医院神经外科，对连续32例患有小脑肿瘤的儿童进行了手术。对他们术前和术后的言语及神经放射学研究进行了系统分析。
10名儿童（32%）在术后早期出现小脑缄默症。肿瘤类型、中线定位和蚓部切口是显著的单一独立危险因素。此外，还发现了可能的危险因素（肿瘤>5厘米、髓母细胞瘤）之间的相互依存关系。缄默症出现的潜伏期为0至90天（平均15.6天）。8例患者的言语恢复正常。所有病例均伴有小脑共济失调。
后颅窝肿瘤切除术后的缄默症也与共济失调有关。小脑缄默症通常有自限性病程且预后良好。
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