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6세 여아의 제4뇌실 맥락총 유두종 제거후 병발한 일과성 함구증
황광호,김태영,김종문 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.12
Transient mutism has been known as a rare complication following a posterior fossa approach to cerebellar tumors, although its pathophysiology remains unclear. Cerebellar mutism may be defined as a transient mutism occurring after a posterior fossa tumor approach in children with unimpaired consciousness, unimpaired symbolic functions, no detectable deficit of cranial nerves or peripheral organs of speech, and no lesions of long pathways in the course of the cranial nerves at the level of the brain stem. Forty two cases in children, and only two cases in adults have been found in the literature. We report a case of transient mutism with oropharyngeal apraxia after total excision of 4th ventricle choroid plexus papilloma in a S-year-old girl Postoperatively the patient becamg mute and refused food intake without disturbance of consciousness, of lower cranial nerve function. Computed tomography(CT) and magnetic resonance image(MRI) demonstrated no abnormal findings except the surgical lesion in the posterior fossa. The mutism tasted for 3 weeks, but she gradually became fluent. The mechanism of "cerebellar mutism" is briefly discussed with literature review.