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小脑缄默症的病因与结局:一项系统评价的证据

Cause and outcome of cerebellar mutism: evidence from a systematic review.

作者信息

Reed-Berendt Rosa, Phillips Bob, Picton Susan, Chumas Paul, Warren Daniel, Livingston John H, Hughes Ellen, Morrall Matthew C H J

机构信息

Paediatric Neuropsychology, The Leeds Teaching Hospitals NHS Trust, Leeds General Infirmary, Great George Street, Leeds, LS1 3EX, UK.

出版信息

Childs Nerv Syst. 2014 Mar;30(3):375-85. doi: 10.1007/s00381-014-2356-0. Epub 2014 Jan 23.

Abstract

PURPOSE

Cerebellar mutism is a serious neurosurgical complication after posterior fossa surgery, but the cause, incidence and outcome remain incompletely defined. The aim of this paper was to identify and review all reports of this phenomenon to better delineate and improve the evidence base.

METHODS

A systematic search and retrieval of databases was conducted using advanced search techniques. Review/outcomes criteria were developed, and study quality was determined.

RESULTS

The retrieval identified 2,281 papers of which 96 were relevant, identifying 650 children with cerebellar mutism. Causative factors, clinical features and outcomes were reported variably; papers focussed on multiple areas, the majority reporting incidence in single or series of case studies with little or no analysis further than description.

CONCLUSIONS

The complexity and variability of data reporting, likely contributing factors and outcomes make cerebellar mutism difficult to predict in incidence and the degree of impact that may ensue. A clear and accepted universal definition would help improve reporting, as would the application of agreed outcome measures. Clear and consistent reporting of surgical technique remains absent. Recommendations for practice are provided.

摘要

目的

小脑缄默症是后颅窝手术后一种严重的神经外科并发症,但其病因、发病率及预后仍未完全明确。本文旨在识别并综述有关该现象的所有报告,以更好地描述并完善证据基础。

方法

采用先进检索技术对数据库进行系统检索。制定了综述/结果标准,并确定了研究质量。

结果

检索出2281篇论文,其中96篇相关,共识别出650例小脑缄默症患儿。病因、临床特征及预后的报告各不相同;论文关注多个领域,大多数报告的是单个或系列病例研究中的发病率,除描述外几乎没有进一步分析。

结论

数据报告的复杂性和变异性、可能的促成因素及预后,使得小脑缄默症的发病率及可能产生的影响程度难以预测。明确且被认可的通用定义将有助于改善报告情况,采用一致认可的结果测量方法也会有同样效果。目前仍缺乏对手术技术清晰且一致的报告。文中给出了实践建议。

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