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Titolo:
THE PATHOPHYSIOLOGY OF ORAL PHARYNGEAL APRAXIA AND MUTISM FOLLOWING POSTERIOR-FOSSA TUMOR RESECTION IN CHILDREN
Autore:
DAILEY AT; MCKHANN GM; BERGER MS;
Indirizzi:
UNIV WASHINGTON,SCH MED,DEPT NEUROL SURG,BOX 356470,1959 NE PACIFIC ST SEATTLE WA 98195 UNIV WASHINGTON,SCH MED,DEPT NEUROL SURG SEATTLE WA 98195 CHILDRENS HOSP,MED CTR SEATTLE WA 00000
Titolo Testata:
Journal of neurosurgery
fascicolo: 3, volume: 83, anno: 1995,
pagine: 467 - 475
SICI:
0022-3085(1995)83:3<467:TPOOPA>2.0.ZU;2-N
Fonte:
ISI
Lingua:
ENG
Soggetto:
TRANSIENT CEREBELLAR MUTISM; DENTATE NUCLEUS; REMOVAL; MEDULLOBLASTOMA; LESIONS; SURGERY; OPERATIONS; CONTRIBUTE; MUTENESS; DISEASE;
Keywords:
MUTISM; APRAXIA; VERMIS; CEREBELLUM; POSTERIOR FOSSA TUMOR;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
52
Recensione:
Indirizzi per estratti:
Citazione:
A.T. Dailey et al., "THE PATHOPHYSIOLOGY OF ORAL PHARYNGEAL APRAXIA AND MUTISM FOLLOWING POSTERIOR-FOSSA TUMOR RESECTION IN CHILDREN", Journal of neurosurgery, 83(3), 1995, pp. 467-475

Abstract

Mutism following posterior fossa tumor resection in pediatric patients has been previously recognized, although its pathophysiology remainsunclear. A review of the available literature reveals 33 individuals with this condition, with only a few adults documented in the population. All of these patients had large midline posterior fossa tumors. Tobetter understand the incidence and anatomical substrate of this syndrome, the authors reviewed a 7-year series of 110 children who underwent a posterior fossa tumor resection. During that time, nine (8.2%) ofthe 110 children exhibited mutism postoperatively. They ranged from 2.5 to 20 years of age (mean 8.1 years) and became mute within 12 to 48hours of surgery. The period of mutism lasted from 1.5 to 12 weeks after onset: all children had difficulty coordinating their oral pharyngeal musculature as manifested by postoperative drooling and inability to swallow. Further analysis of these cases revealed that all childrenhad splitting of the entire inferior vermis at surgery, as confirmed on postoperative magnetic resonance studies. Lower cranial nerve function was intact in all nine patients. Current concepts of cerebellar physiology emphasize the importance of the cerebellum in learning and language. The syndrome described resembles a loss of learned activities,or an apraxia, of the oral and pharyngeal musculature. To avoid the apraxia, therefore, the inferior vermis must be preserved. For large midline tumors that extend to the aqueduct, a combined approach through the fourth ventricle and a midvermis split may be used to avoid injuring the inferior vermis.

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Documento generato il 01/10/20 alle ore 01:19:04