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Titolo:
Bilateral crossed cerebello-cerebral diaschisis and mutism after surgery for cerebellar medulloblastoma
Autore:
Sagiuchi, T; Ishii, K; Aoki, Y; Kan, S; Utsuki, S; Tanaka, R; Fujli, K; Hayakawa, K;
Indirizzi:
Kitasato Univ, Sch Med, Dept Radiol, Sagamihara, Kanagawa 2288555, Japan Kitasato Univ Sagamihara Kanagawa Japan 2288555 , Kanagawa 2288555, Japan Kitasato Univ, Sch Med, Dept Neurosurg, Sagamihara, Kanagawa 2288555, Japan Kitasato Univ Sagamihara Kanagawa Japan 2288555 , Kanagawa 2288555, Japan
Titolo Testata:
ANNALS OF NUCLEAR MEDICINE
fascicolo: 2, volume: 15, anno: 2001,
pagine: 157 - 160
SICI:
0914-7187(200104)15:2<157:BCCDAM>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
SUPPLEMENTARY MOTOR AREA; POSTERIOR-FOSSA TUMOR; BLOOD-FLOW; CHILDREN; PATHOPHYSIOLOGY; INFARCTION; RESECTION; RECOVERY; APRAXIA; REMOVAL;
Keywords:
crossed cerebello-cerebral diaschisis; cerebellar mutism; medulloblastoma; single photon emission computed tomography; technetium-99m-ethyl cysteinate dimer;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
24
Recensione:
Indirizzi per estratti:
Indirizzo: Sagiuchi, T Kitasato Univ, Sch Med, Dept Radiol, 1-15-1 Kitasato, Sagamihara, Kanagawa2288555, Japan Kitasato Univ 1-15-1 Kitasato Sagamihara Kanagawa Japan 2288555
Citazione:
T. Sagiuchi et al., "Bilateral crossed cerebello-cerebral diaschisis and mutism after surgery for cerebellar medulloblastoma", ANN NUCL M, 15(2), 2001, pp. 157-160

Abstract

A 7-year-old boy developed mutism after surgery for cerebellar medulloblastoma. Postoperative magnetic resonance imaging (MRI) showed atrophy of the cerebellar vermis and both cerebellar hemispheres, predominantly on the right side. Single photon emission computed tomography (SPECT) with technetium-99m-ethyl cysteinate dimer (Tc-99m ECD) revealed decreased cerebral blood flow (CBF) in the bilateral thalami, bilateral medial frontal lobes, and left temporal lobe in addition to the cerebellar vermis and both cerebellar hemispheres when mutism was manifest, indicating the existence of bilateral crossed cerebello-cerebral diaschisis (BCCCD). Circulatory disturbance in both cerebellar hemispheres secondary to tumor resection probably caused BCCCD in both cerebral hemispheres, predominantly in the left, via the dentatothalamocortical pathway (DTCP). With recovery of his mutism, CBF increased in the right thalamus, bilateral medial frontal lobes and left temporal lobe. Thus BCCCD was improved, with only a slight decrease in CBF still persisting in the left thalamus. The mechanism of mutism may have involved damageto the cerebellar vermis (the site of incision at operation), the left dentate nucleus (heavily infiltrated by the tumor) and the right dentate nucleus of the cerebellum (affected by circulatory disturbance secondary to acute postoperative edema). The SPECT findings suggested that mutism was associated with BCCCD-induced cerebral circulatory and metabolic hypofunction in the supplementary motor area mediated via the DTCP.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 19/01/20 alle ore 11:39:07