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Article: Bilateral crossed cerebello-cerebral diaschisis and mutism after surgery for cerebellar medulloblastoma

TitleBilateral crossed cerebello-cerebral diaschisis and mutism after surgery for cerebellar medulloblastoma
Authors
KeywordsCerebellar mutism
Technetium-99m-ethyl cysteinate dimer
Single photon emission computed tomography
Medulloblastoma
Crossed cerebello-cerebral diaschisis
Issue Date2001
Citation
Annals of Nuclear Medicine, 2001, v. 15, n. 2, p. 157-160 How to Cite?
AbstractA 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 damage to 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.
Persistent Identifierhttp://hdl.handle.net/10722/223094
ISSN
2015 Impact Factor: 1.467
2015 SCImago Journal Rankings: 0.680
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorSagiuchi, T.-
dc.contributor.authorIshii, K.-
dc.contributor.authorAoki, Y.-
dc.contributor.authorKan, S.-
dc.contributor.authorUtsuki, S.-
dc.contributor.authorTanaka, R.-
dc.contributor.authorFujii, K.-
dc.contributor.authorHayakawa, K.-
dc.date.accessioned2016-02-19T02:37:43Z-
dc.date.available2016-02-19T02:37:43Z-
dc.date.issued2001-
dc.identifier.citationAnnals of Nuclear Medicine, 2001, v. 15, n. 2, p. 157-160-
dc.identifier.issn0914-7187-
dc.identifier.urihttp://hdl.handle.net/10722/223094-
dc.description.abstractA 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 damage to 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.-
dc.languageeng-
dc.relation.ispartofAnnals of Nuclear Medicine-
dc.subjectCerebellar mutism-
dc.subjectTechnetium-99m-ethyl cysteinate dimer-
dc.subjectSingle photon emission computed tomography-
dc.subjectMedulloblastoma-
dc.subjectCrossed cerebello-cerebral diaschisis-
dc.titleBilateral crossed cerebello-cerebral diaschisis and mutism after surgery for cerebellar medulloblastoma-
dc.typeArticle-
dc.description.natureLink_to_subscribed_fulltext-
dc.identifier.pmid11448076-
dc.identifier.scopuseid_2-s2.0-0034993129-
dc.identifier.volume15-
dc.identifier.issue2-
dc.identifier.spage157-
dc.identifier.epage160-
dc.identifier.isiWOS:000168843800014-

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