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Mechanism of mutism following the transcallosal approach to the ventricles

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Summary

Transient mutism has been known as a common manifestation following callosotomy for medically intractable epilepsy, but its cause has not been clearly elucidated. In this paper, we report three cases of mutism following a transcallosal approach to tumours in the lateral and third ventricles and retrospectively analyze the surgical, neurological and radiological features which may suggest the cause of this type of mutism.

Mutism may be a result of division of the corpus callosum. Suppression of the limbic system caused by lesions in the anterior cingulate gyrus, septum pellucidum, and fornix may have been of importance in at least two of these three cases. Impairments of the supplementary motor cortex, thalamus and basal ganglia may also be factors reducing speech production. The mechanism of such transient mutism seems to be a complex of two or more of these factors, and their combinations may be different from one case to the other.

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References

  1. Alexander MP, LoVerme SR Jr (1980) Aphasia after left hemispheric intracerebral haemorrhage. Neurology 30: 1193–1202

    PubMed  Google Scholar 

  2. Altshuler LL, Cummings JL, Mills MJ (1986) Mutism: review, differential diagnosis, and report of 22 cases. Amer J Psychiatry 143: 1409–1414

    Google Scholar 

  3. Apuzzo MLJ, Chikovani OK, Gott PS,et al (1982) Transcallosal, interfornicial approaches for lesions affecting the third ventricle: surgical considerations and consequences. Neurosurgery 10: 547–554

    PubMed  Google Scholar 

  4. Bogen JE (1985) Split-brain syndromes. In: Frederiks JAM (ed) Handbook of clinical neurology, vol I. Elsevier, Amsterdam, pp 99–106

    Google Scholar 

  5. Bogen JE (1987) Physiological consequences of complete or partial commissural section. In: Apuzzo MLJ (ed) Surgery of the third ventricle. Williams &Wilkins, Baltimore London Los Angeles Sydney, pp 175–194

    Google Scholar 

  6. Benson DF (1979) Aphasia, alexia, and agraphia. Churchill Livingstone, New York Edinburgh London, pp 163–164

    Google Scholar 

  7. Brust JCM, Plank C, Burke A,et al (1982) Language disorder in a right-hander after occlusion of the right anterior cerebral artery. Neurology 32: 492–497

    PubMed  Google Scholar 

  8. Cummings JL, Benson DF, Houlihan JP,et al (1983) Mutism: loss of neocortical and limbic vocalization. J Nerv Ment Dis 171: 255–259

    PubMed  Google Scholar 

  9. David AS, Bone I (1984) Mutism following left hemisphere infarction. J Neurol Neurosurg Psychiatry 47: 1342–1344

    PubMed  Google Scholar 

  10. Diamond SJ, Scammell RE, Brouwers EYM,et al (1977) Functions of the centre section (trunk) of the corpus callosum in man. Brain 100: 543–562

    PubMed  Google Scholar 

  11. Ferrante L, Mastronardi L, Acqui M,et al (1990) Mutism after posterior fossa surgery in children. J Neurosurg 72: 959–963

    PubMed  Google Scholar 

  12. Ferrara VL (1985) Acute traumatic mutism. Surg Neurol 23: 573–574

    PubMed  Google Scholar 

  13. Geuna E, Regalia F, Pappada G,et al (1981) Septum pellucidum oligodendroglioma. Case report and review of literature. J Neurosurg Sci 25: 49–53

    PubMed  Google Scholar 

  14. Gordon HW, Bogen JE, Sperry RW (1971) Absence of deconnexion syndrome in two patients with partial section of the neocommissures. Brain 94: 327–336

    PubMed  Google Scholar 

  15. Jeeves MA, Simpson DA, Geffen G (1979) Functional consequences of the transcallosal removal of intraventricular tumours. J Neurol Neurosurg Psychiatry 42: 134–142

    PubMed  Google Scholar 

  16. Liepmann H, Maas O (1907) Fall von linksseitiger Agraphie und Apraxie bei rechtsseitiger Lähmung. J Psychol Neurol 10: 214–227

    Google Scholar 

  17. Oepen G, Schulz-Weiling R, Zimmermann P,et al (1985) Longterm effects of partial callosal lesions. Preliminary report. Acta Neurochir (Wien) 77: 22–28

    Google Scholar 

  18. Rayport M, Ferguson SM, Corrie WS (1984) Mutism after corpus callosum section for intractable seizure control. Epilepsia 25: 665

    Google Scholar 

  19. Rekate HL, Grubb RL, Aram DM,et al (1985) Muteness of cerebellar origin. Arch Neurol 42: 697–698

    PubMed  Google Scholar 

  20. Ross MK, Reeves AG, Roberts DW (1984) Postcommissurotomy mutism. Ann Neurol 16: 114

    Google Scholar 

  21. Sass KJ, Novelly RA, Spencer DD,et al (1990) Postcallosotomy language impairments in patients with crossed cerebral dominance. J Neurosurg 72: 85–90

    PubMed  Google Scholar 

  22. Shucart WA, Stein BM (1978) Transcallosal approach to the anterior ventricular system. Neurosurgery 3: 339–343

    PubMed  Google Scholar 

  23. Sussman NM, Gur RC, Gur RE,et al (1983) Mutism as a consequence of callosotomy. J Neurosurg 59: 514–519

    PubMed  Google Scholar 

  24. Watson RT, Heilman KM (1983) Callosal apraxia. Brain 106: 391–403

    PubMed  Google Scholar 

  25. Wilson DH, Reeves A, Gazzaniga M,et al (1977) Cerebral commissurotomy for control of intractable seizures. Neurology 27: 708–715

    PubMed  Google Scholar 

  26. Winston KR, Cavazzuti V, Arkins T (1979) Absence of neurological and behavioural abnormalities after anterior transcallosal operation for third ventricular lesions. Neurosurgery 4: 386–393

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery, Shiga University of Medical Science, Ohtsu, Japan

    Y. Nakasu, T. Isozumi, H. Nioka & J. Handa

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  1. Y. Nakasu
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  2. T. Isozumi
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  3. H. Nioka
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  4. J. Handa
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Nakasu, Y., Isozumi, T., Nioka, H. et al. Mechanism of mutism following the transcallosal approach to the ventricles. Acta neurochir 110, 146–153 (1991). https://doi.org/10.1007/BF01400683

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  • DOI: https://doi.org/10.1007/BF01400683

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