2019 Volume 19 Issue 1 Pages 3-9
A variety of cognitive dysfunctions occur after subcortical damage. Aphasia and unilateral spatial neglect often result from lesions of the putamen and thalamus. They are particularly frequent during the acute stage of cerebral hemorrhage, with approximately 80 % of patients presenting such symptoms. To understand the mechanism by which they appear, we must not only consider causes related to damage to the subcortical white matter fibers, but also secondary functional decline caused by direct damage to the cortex as well as by diaschisis. Infratentorial lesions are known to cause language deficits, visuospatial inattention, executive function disorders, personal change, and other symptoms. Many of these reports pertain to cerebellar lesions; however, there are not a few cases where cognitive dysfunction develops because of brainstem lesions. Impairment of the cortical pontocerebellar tract’s fiber connections and damage to the brainstem reticular regulatory system may be considered as the mechanism by which cognitive dysfunction appears. Because of this, detailed cognitive function assessments must also be performed for patients with infratentorial lesions.
