小脑性缄默4例报告及文献复习  

Cerebellar Mutism: Report of Four Cases and Review of Literature

作　　者：李美华[1] 曾春晖[1] 洪涛[1] 李东海[1] 李义云[1] 徐庚生[1] 

机构地区：[1]江西医学院第一附属医院神经外科,江西南昌330006

出　　处：《中国临床神经外科杂志》2005年第1期20-21,24,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨后颅窝手术后小脑性缄默的临床特点及其形成的病理生理机制。方法回顾性总结分析我科4例和英文文献报告的137例共141例后颅窝手术后出现的小脑性缄默病例。结果儿童病例127例,占90.1%。手术病变位于小脑蚓部者125例(88.7%)。小脑性缄默均为暂时性,发生的平均潜伏期和持续时间分别为1.7d和56.2d。结论小脑性缄默多见于儿童小脑蚓部肿瘤手术后其发生机制可能与小脑齿状核丘脑腹外侧核运动区和辅助运动区之间的纤维联系的直接或间接损害有关。Objective To explore the clinical features and pathogenesis of the cerebellar mutism after posterior fossa surgery for the intracranial tumors. Methods We reviewed 137 cases of cerebellar mutism reported in English literature. The clinical and imaging data of 4 patients with cerebellar mutism after the posterior fossa surgery were analysed retrospectively. Results The children (127) accounted for 90.1% of the patients with cerebellar mutism (141). The lesions of 125 patients (88.7%) were located in the cerebellar vermis. The mutism was transient in all the cases and its latent period and duration were 1.7 days and 56.2 days averagely. Conclusions The cerebellar mutism is more common in the children than that in the adults after the surgery for the tumor in the posterior fossa, especially in the cerebellar vermis. It is hypothesized that the damage to the reciprocal fibres connecting the cerebellar dentate neucleib and ventrolateral neuclei of thalamus, with the motor areas and supplementary motor areas is possibly responsible for the cerebellar mutism after posterior fossa surgery.

关 键 词：小脑性缄默 后颅窝肿瘤 神经外科手术 儿童 

分 类 号：R742.82[医药卫生—神经病学与精神病学]