A Case of Muteness of Cerebellar Origin

To the Editor. —We read with great interest the article by Rekate et al1entitled "Muteness of Cerebellar Origin." We have an additional case to report. Report of a Case. —An 8-year-old girl presented with three months of headache, occasional early morning vomiting, three weeks of progressive papilledema, a mild right sixth-nerve paresis, and an enhancing fourth-ventricle mass greater than 4 cm in diameter, with secondary hydrocephalus on computed tomography (CT). A right-sided ventriculostomy and suboccipital craniectomy were performed on April 21, 1985, with the patient in the prone position. Immediately prior to opening the dura, 13 mL of cerebrospinal fluid was drained. A medulloblastoma was removed from the fourth ventricle after the vermis of the cerebellum was divided. The tumor occupied the entire fourth ventricle and obstructed the aqueduct of Sylvius. In the recovery room, the patient had a mild right hemiparesis and uttered only the phrase "ma