Department of Neurosciences, Biomedicine and Movement Sciences - Neurosurgery Unit , University of Verona, Piazzale Stefani 1, 37126, Verona, Italy.
Childs Nerv Syst. 2022 Oct;38(10):1993-1997. doi: 10.1007/s00381-022-05497-5. Epub 2022 Mar 25.
Children undergoing surgical removal of tumors in the posterior cranial fossa can encounter a varied and complex constellation of neurological symptoms, called cerebellar mutism, defined as a disturbance in the planning and programming of motor language with preserved understanding, behavioral disorders such as inattention, visual-spatial disorganization, personality change, as well as ataxia and dysmetria. In the last years, several groups have been trying to establish risk factors or even predictive scores in order to be able at least in part to predict the appearance of speech disorders before surgery. We report on a child with pilocytic astrocytoma of the cerebellar vermis who had already been diagnosed with developmental linguistic delay two years earlier. This disorder initially worsened after surgery and later improved in the following 12 months. The aim of this paper is to emphasize the importance of preoperative neuropsychological evaluation. The present case, along with those reported in the literature, suggests that the risk of long-term cerebellar mutism is higher in children with preoperative speech disorders. In these patients a thorough assessment of cognitive and linguistic functions is therefore necessary to better evaluate the risk of cerebellar mutism after surgery.
接受颅后窝肿瘤手术的儿童可能会遇到一系列不同且复杂的神经症状，称为小脑缄默症，其定义为运动语言的计划和编程障碍，伴有保留的理解、行为障碍如注意力不集中、视觉空间组织障碍、人格改变以及共济失调和运动失调。在过去的几年中，已经有几个小组试图确定风险因素甚至预测评分，以便至少部分地能够在手术前预测言语障碍的出现。我们报告了一例小脑蚓部毛细胞星形细胞瘤患儿，他在两年前就已经被诊断为发育性语言延迟。该障碍在手术后最初恶化，随后在接下来的 12 个月内得到改善。本文的目的是强调术前神经心理学评估的重要性。本病例以及文献中的病例表明，术前言语障碍的儿童发生长期小脑缄默症的风险更高。因此，对于这些患者，有必要对认知和语言功能进行全面评估，以更好地评估手术后小脑缄默症的风险。
