儿童后颅窝术后小脑性缄默综合征的临床分析

Clinical studies of cerebellar mutism syndrome after posterior fossa surgery in children

目的探讨儿童后颅窝术后并发小脑性缄默综合征的相关危险因素及其发病机制。方法回顾性分析本院神经外科自2004年1月至2014年12月收治的16例继发小脑性缄默综合征患儿临床资料，分析其临床特征及危险因素，结合文献探讨其发病机制。结果16例患儿中，因后颅窝病变行手术治疗14例，保守治疗2例，经保守治疗的2例和14例术后患儿均继发不同程度的小脑性缄默综合征并伴有其他神经功能障碍，于术后2—6d出现缄默，持续约2周至3个月不等，大部分患儿缄默好转后仍有持续1～3个月的语言障碍。结论儿童后颅窝病变，特别是大型小脑蚓部肿瘤术后，易发生小脑性缄默综合征，有一定的潜伏期，预后良好。

Objetive To investigate the child after posterior fossa lesions postoperative cerebellar mut- ism syndrome related risk factors and pathogenesis. Methods A retrospective analysis was made on 16 cases of secondary cerebellar mutism syndrome treated in Department of Neurosurgery in our hospital from Jan 2004 to Dec 2014. The clinical features and risk factors were analyzed and the pathogenesis of literature were investiga- ted. Results Due to posterior fossa lesions underwent surgery 14 cases,2 cases of conservative treatment, con- servative treatment of 2 patients and 14 cases of postoperative patients were secondary to varying degrees of cer- ebellar mutism syndrome and associated with other neurological disorders appeared silent in 2 - 6 days after sur- gery, which lasted about 2 weeks to 3 months to still continue the language barrier after 1 ~ 3 months of silence most of the children improved. Conclusions Children with fossa lesions, especially large tumor surgery cere- bellar vermis, are more likely to suffer from cerebellar mutism syndrome prone. There is a certain incubation pe- riod, but with favourable prognosis.