術後一過性に無言症を呈した左前頭葉星細胞腫の1例

Transient mutism after resection of left frontal lobe astrocytoma in adult:case report

I．はじめに

　脳外科的手術後に無言症（mutism）を呈することがあるが，なかでも小児小脳虫部腫瘍の術後に一過性に無言症を呈することはよく知られている^6,8,9,19）．今回われわれは，左前頭葉内に発生した悪性星細胞腫の摘出後に一過性に無言症を呈した稀な症例を経験したので，その発生機序を中心に報告する．

We reported a case of a 32-year-old female who had a transient mutism after resection of a malignant astrocytoma in the left frontal lobe. Preoperatively magnetic resonance (MR) imaging revealed a cystic tumor in the left frontal lobe. The patient underwent surgery. She was alert but did not speak immediately after surgery. She could follow verbal commands, com-prehend written language, and write letters. She had no cranial nerve or extremity paresis. Seven days postoper-atively, she began to say simple words, and one month postoperatively she could talk normally.

Postoperative MR imaging revealed a hypointensity area on T1 weighted image in the frontal lobe including a part of the anterior cingulate cortex and the anterior part of the corpus callosum. It appears that a dominant hemisphere lesion of both the anterior cingulate cortex and the corpus callosum may be responsible for the de-velopment of postoperative mutism.