Salvati M, Cervoni L, Santoro A
Department of Neurological Sciences, Neurosurgery La Sapienza, University of Rome, Italy.
J Neurosurg Sci. 1996 Mar;40(1):59-63.
Mutism is a rare sequel of PCF tumor removal. Three patients aged 5 to 20 years old with mutism after posterior fossa surgery are presented. Suboccipital craniectomy was performed in all patients with grossly total removal of a medulloblastoma. The mutism that may occur after an operation for a PCF lesion has been explained in functional and/or organic terms. To date, 24 similar cases of mutism following cerebellar operations have been reported in the literature. We review the features of the syndrome in the light of the published cases and speculate on the underlying physiopathology. The absence of long tract or other brain stem signs, together with a presence of dysarthria during the recovery of speech, suggested a organic cerebellar cause of the mutism.
缄默症是后颅窝肿瘤切除术后罕见的后遗症。本文报告了3例年龄在5至20岁之间，后颅窝手术后出现缄默症的患者。所有患者均接受了枕下颅骨切除术，髓母细胞瘤大体上完全切除。针对后颅窝病变手术后可能出现的缄默症，已从功能和/或器质性方面进行了解释。迄今为止，文献中已报道了24例小脑手术后类似的缄默症病例。我们根据已发表的病例回顾了该综合征的特征，并推测其潜在的生理病理学机制。缺乏长束征或其他脑干体征，以及在言语恢复过程中存在构音障碍，提示缄默症的病因是器质性小脑病变。
