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Titolo:
Neurological dysfunction associated with postoperative cerebellar mutism
Autore:
Siffert, J; Poussaint, TY; Goumnerova, LC; Scott, RM; LaValley, B; Tarbell, NJ; Pomeroy, SL;
Indirizzi:
Beth Israel Med Ctr, Hyman Newman Inst Neurol & Neurosurg, New York, NY 10028 USA Beth Israel Med Ctr New York NY USA 10028 urosurg, New York, NY 10028 USA Dana Farber Canc Inst, Dept Pediat Oncol, Boston, MA 02115 USA Dana FarberCanc Inst Boston MA USA 02115 iat Oncol, Boston, MA 02115 USA Childrens Hosp, Dept Radiol, Boston, MA 02115 USA Childrens Hosp Boston MA USA 02115 osp, Dept Radiol, Boston, MA 02115 USA Childrens Hosp, Dept Neurosurg, Boston, MA 02115 USA Childrens Hosp Boston MA USA 02115 , Dept Neurosurg, Boston, MA 02115 USA Harvard Univ, Massachusetts Gen Hosp, Sch Med, Div Radiat Oncol, Boston, MA USA Harvard Univ Boston MA USA sp, Sch Med, Div Radiat Oncol, Boston, MA USA
Titolo Testata:
JOURNAL OF NEURO-ONCOLOGY
fascicolo: 1, volume: 48, anno: 2000,
pagine: 75 - 81
SICI:
0167-594X(200005)48:1<75:NDAWPC>2.0.ZU;2-C
Fonte:
ISI
Lingua:
ENG
Soggetto:
POSTERIOR-FOSSA SURGERY; PERIOPERATIVE FACTORS; CHILDREN; TUMORS; PATHOPHYSIOLOGY; MEDULLOBLASTOMA; INTELLIGENCE; DYSARTHRIA; RESECTION; COGNITION;
Keywords:
cerebellar mutism; akinetic mutism; medulloblastoma; posterior fossa syndrome; brain tumor;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
33
Recensione:
Indirizzi per estratti:
Indirizzo: Siffert, J Beth Israel Med Ctr, Hyman Newman Inst Neurol & Neurosurg, 170 E End Ave, New York, NY 10028 USA Beth Israel Med Ctr 170 E End Ave New York NY USA 10028 028 USA
Citazione:
J. Siffert et al., "Neurological dysfunction associated with postoperative cerebellar mutism", J NEURO-ONC, 48(1), 2000, pp. 75-81

Abstract

Background and objectives. The postoperative cerebellar mutism syndrome (CMS) is an unique acute postoperative complication characterized by transient decrease in speech output (often mutism), apathy, irritability as well asglobal cerebellar dysfunction. As much as 25% of patients undergoing a resection of a cerebellar or IV ventricular tumor may develop such a syndrome. In this retrospective study we characterize the clinical features of the CMS and explore potential etiologic mechanisms. Methods. We conducted a retrospective analysis of medical records and imaging tests of 8 consecutive patients with the CMS identified through the database of the Children's Hospital and Dana-Farber Cancer Institute, Boston, and compared with a control group of 8 unaffected children undergoing a comparable tumor resection. Results. In contrast to the control group, children in the affected group had marked decrease in speech output and comprehension, apathy and lack of initiative, inattention, persistent eye closure, flaccid hemiparesis and a severe global cerebellar dysfunction. Swallowing difficulties and bowel andbladder dysfunction were also observed. The median duration of the syndrome as judged by the persistence of the communication abnormalities was 4 weeks. The recovery was near complete with exception for a persistent global cerebellar dysfunction. A comparison of CT and MRI scans of children in bothgroups failed to identify distinguishing features. Conclusion. A surgical lesion of the midline cerebellum can cause a complex neurological dysfunction such as the CMS. Thus, we postulate that the cerebellum and its connections function as a 'modulatory system' in control ofboth motor and non-motor functions, including attention and language.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 09/07/20 alle ore 15:40:44