Stroke Rehabilitation in a Patient with Cerebellar Cognitive Affective Syndrome
Brain Injury, July 2007; 21(8): 877–883
CASE REPORT
Stroke rehabilitation in a patient with cerebellar cognitive affective syndrome
SHINICHIRO MAESHIMA & AIKO OSAWA
Department of Rehabilitation Medicine, Kawasaki Medical School, Kawasaki Hospital, Japan
Brain Inj Downloaded from informahealthcare.com by University of Toronto on 01/24/12 For personal use only.
(Received 1 August 2006; accepted 11 June 2007)
Abstract Objective: It has become evident that the cerebellum plays a role in cognitive function, and Schmahmann et al. have introduced the term ‘‘Cerebellar cognitive affective syndrome (CCAS).’’ In the present paper we report a patient with cerebellar hemorrhage who developed CCAS. Design: A case study. Methods: The patient was a 61-year-old right-handed man who was admitted to our hospital because of sudden headache, dizziness and vomiting. The patient showed ataxia of the trunk and the extremities, but no paralysis and disturbance of sensation. He was disoriented in time and showed recent memory disturbance, disturbance of attention, impairment of executive functions and reduced volition, and due to these symptoms, his daily living was also severely impaired. Results: With the aim of returning home, the patient received exercise therapy and cognitive rehabilitation, while home modification was performed, and living at home under the supervision of his family became possible. Cognitive function improved, while memory and attention disturbance, impairment of executive function remained. Conslusion: Cognitive dysfunction in patients with cerebellar damage is assumed to develop from disturbance of the cerebrocerebellar circuit, and that rehabilitation of these patients must include assessment of not only the motor function, but also of detailed assessment of cerebral function. Keywords: Cerebellum, cognition, rehabilitation, diaschisis
Introduction While it is established that the cerebellum is a neural structure responsible for the
CASE REPORT
Stroke rehabilitation in a patient with cerebellar cognitive affective syndrome
SHINICHIRO MAESHIMA & AIKO OSAWA
Department of Rehabilitation Medicine, Kawasaki Medical School, Kawasaki Hospital, Japan
Brain Inj Downloaded from informahealthcare.com by University of Toronto on 01/24/12 For personal use only.
(Received 1 August 2006; accepted 11 June 2007)
Abstract Objective: It has become evident that the cerebellum plays a role in cognitive function, and Schmahmann et al. have introduced the term ‘‘Cerebellar cognitive affective syndrome (CCAS).’’ In the present paper we report a patient with cerebellar hemorrhage who developed CCAS. Design: A case study. Methods: The patient was a 61-year-old right-handed man who was admitted to our hospital because of sudden headache, dizziness and vomiting. The patient showed ataxia of the trunk and the extremities, but no paralysis and disturbance of sensation. He was disoriented in time and showed recent memory disturbance, disturbance of attention, impairment of executive functions and reduced volition, and due to these symptoms, his daily living was also severely impaired. Results: With the aim of returning home, the patient received exercise therapy and cognitive rehabilitation, while home modification was performed, and living at home under the supervision of his family became possible. Cognitive function improved, while memory and attention disturbance, impairment of executive function remained. Conslusion: Cognitive dysfunction in patients with cerebellar damage is assumed to develop from disturbance of the cerebrocerebellar circuit, and that rehabilitation of these patients must include assessment of not only the motor function, but also of detailed assessment of cerebral function. Keywords: Cerebellum, cognition, rehabilitation, diaschisis
Introduction While it is established that the cerebellum is a neural structure responsible for the
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