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Yıl:2013; Cilt: 50; Sayı: 4>> Özet
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Nöropsikiyatri Arşivi; 2013;50(4):368-371
Posterior Fossa Cerrahisi Sonrası Ortaya Çıkan Serebellar Mutizm Sendromu: Pilositik Astrositoma Tanılı İki Olgunun Sunumu
HB Gündüz, MİK Yassa, AE Ofluoğlu, L Postalcı, E Emel
Bakırköy Prof.Dr.Mazhar Osman Ruh ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi, İstanbul
Serebellar mutizm sendromu posterior fossa cerrahisi sonrası azalmış konuşma, hipotoni, ataksi ve duygusal kararsızlık ile kendini gösteren bir sendromdur. İlk kez 1985 yılında ayrı makalelerde Rekate ile arkadaşları ve Yonemasu tarafından rapor edilmişlerdir. Anlamanın korunmuş olmasının, uzun trakt bulgularının ve alt kranyal sinir tutulumunun bu sendromda görülmediğinin iyi bilinmesine rağmen, serebellar mutizmin patofizyolojisi henüz ayrıntılı olarak açığa çıkarılamamıştır. Sıklıkla medulloblastomalı ve beyin sapı tutulumu olan hastalarda görülmektedir. Posterior fossa cerrahisi uyguladığımız iki olgumuzda serebellar mutizm sendromu gelişmiştir. Kabul edilen risk faktörlerinin dışında, histopatolojik inceleme sonucunun pilositik astrositoma gelmesi nedeniyle sıra dışı olarak kabul ettiğimiz bu iki olguyu sunmaktayız.
Cerebellar Mutism Syndrome After Posterior Fossa Surgery: A Report of Two Cases of Pilocytic Astrocytoma
Cerebellar mutism is a type of syndrome including decreased speech, hypotonia, ataxia and emotional instability which occurs after posterior fossa surgery. It has been first reported by Rekate et al. and Yonemasu in 1985. It is well known that long tract signs and lower cranial nerve involvement are not seen with this syndrome and understanding is preserved. However, the pathophysiology of cerebellar mutism has not been well clarified yet. It is mainly seen in patients with medulloblastoma and brainstem involvement. In this report, we present two extraordinary cases of cerebellar mutism after posterior fossa surgery. They were considered extraordinary because their hystopathological analysis results yielded pilocytic astrocytoma which is out of the predefined risk factors.

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