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Yıl:2013; Cilt: 14; Sayı: 1>> Özet
TAM METİN
Anadolu Psikiyatri Dergisi; 2013;14(1):90-92
Şizofreni ve mega sisterna magna: Olgu sunumu
S Karayılan, A Erol
Sakarya Üniversitesi Tıp Fakültesi
Mega sisterna magna, posterior fossanın gelişimsel bir malformasyonudur ve morfolojik olarak vermis ve sere-bellar hemisferler etkilenmemiştir. Bu anomalinin psikiyatrik bozukluklarla ilişkisi vurgulanmış olmakla birlikte, doğası tam olarak anlaşılamamıştır. Mega sisterna magna saptanan bir şizofreni olgusu sunuyoruz. Otuz beş yaşında, kadın, evli, ev kadını, ilkokul mezunu hasta yakınları tarafından dağınık ve uygunsuz konuşma, tuhaf davranma belirtileri ile kliniğimize getirildi. İşitsel ve görsel varsanılar, alınma ve kötülük görme sanrıları vardı. Nörolojik muayenesi ve EEG incelemesi normaldi, fakat kraniyal manyetik rezonans görüntülemesinde mega sisterna magna saptandı. Mega sisterna magnanın psikozla ilişkisi ve klinik önemi tam olarak tanımlanmamıştır. Andreasen’in ‘bilişsel dismetri’ varsayımında serebellumun şizofrenideki rolü vurgulanmıştır. Bu varsayım, şizofre-ni hastalarında görülen sensorimotor ve zihinsel süreçlerin genel bir eşgüdüm bozukluğunda serebellumun rolü olduğunu öne sürmektedir. Şizofreni hastalarında da hareket ve sözel akıcılıkla ilgili sorunlar olduğu bilinmektedir. Bu olgu bağlamında serebellar anomaliler ile şizofreni ilişkisi gözden geçirilmiştir.
Schizophrenia and mega cisterna magna: case report
Mega cisterna magna (MCM) is a developmental malformation of the posterior fossa, morphologically vermis and cerebellar hemispheres are intact. Although the relationship between this anomaly and psychiatric disorders is emphasized, its nature has not fully understood. In this article, we report a case of schizophrenia detected mega cisterna magna. A 35-year-old, married, housewife, graduated from primary school, female patient was brought to our clinic by her relatives with complaints of disorganized and inappropriate speech, strange behavior. She had auditory and visual hallucinations, delusions of reference and persecution. Neurological examination and EEG examination were normal, but mega cisterna magna was disclosed in her cranial magnetic resonance imaging scan. The relationship between psychosis and clinical significance of MCM has not defined completely yet. The role of the cerebellum in schizophrenia has been highlighted by Andreasen’s hypothesis of ‘cognitive dysmetria’. This hypothesis suggests that cerebellum has a role in general dyscoordination of sensorimotor and mental processes which are seen in schizophrenic patients. Schizophrenic patients are known to have problems about memory and verbal fluency, too. In the context of this case, the relationship of schizophrenia with cerebellar anomalies was reviewed.

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