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Callosal mutism after AVM embolization in territoy of distal anterior cerebral artery branches
Author(s) -
Tobias A. Mattei,
Paulo Henrique Pires de Aguiar,
José Guilherme Mendes Pereira Caldas,
Aline Bortolotto Di Pace,
Samanta Saeko Momoi Presotto,
Daniel Pereira Mandarino,
Josias Alécio Mattei
Publication year - 2018
Publication title -
jornal brasileiro de neurocirurgia
Language(s) - English
Resource type - Journals
eISSN - 2446-6786
pISSN - 0103-5118
DOI - 10.22290/jbnc.v17i2.1613
Subject(s) - anterior cerebral artery , anterior choroidal artery , medicine , corpus callosum , embolization , anterior communicating artery , presentation (obstetrics) , lesion , complication , radiology , middle cerebral artery , surgery , anatomy , aneurysm , cardiology , ischemia
 Callosum mutism (CM) is a rare complication of neurosurgical procedures. There is no previous report of its ocurrence after interventional endovascular procedures for intracranial lesions. Material and method: We present a case of CM after embolization of anterior cerebral artery branches for treatment of a left frontal arterio-venous malformation (AVM). After reporting the particularities of clinical and radiological presentation of such case, we preform a critical literature review and discusses the clinical and ethiological aspects of CM as well as its differences in relation to other genders of speech disturbances (like aphasias). Finally we provide a brief overview about present available methods of cortical function monitoring emphasizing their utility in therapeutic endovascular procedures in eloquent areas. Result and conclusion: In literature, there are no previous report of CM as a complication of therapeutic angiographic procedures. Its exact pathophysiology is unknown. It is usually believed that this syndrome may appear after lesion of any of the components of the dentate-thalamic-cortical pathway, as well as supplementary motor area and mesolimbic regions involved in speech production. The diagnosis of CM must be considered after a clinical picture of speech deficit after therapeutic endovascualr procedures in territory of distal branches of anterior cerebral artery, specially of frontopolar (FpA branch) and anterior internal frontal (AIFA) branches. 

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