Abstract
A 59-year-old female was admitted to hospital due to sudden dizziness and vomiting. Brain MRI of the patient revealed an acute cerebellar infarction in the left superior cerebellar artery (SCA) territory. The symptom of cerebellar ataxia improved gradually. Although her consciousness was clear, marked impairment of cognitive functions, including memory/executive functions, was noted at 5 days after admission. On SPECT imaging, the cerebral blood flow (CBF) was found to be decreased over a wide area that included the bilateral basal ganglia, cerebellum, temporal lobe, parietal lobe, and frontal lobe. Cognitive functions became rapidly improved as the CBF improved after 1-2 months. This patient was considered to have cerebellar cognitive affective syndrome (CCAS) due to cerebellar infarction. It has been reported previously that behavioral disorders can appear with dysfunctions of the posterior cerebellum; that affective symptoms are associated with dysfunctions of the cerebellar vermis; and that cognitive dysfunctions are associated with the area supplied by the posterior inferior cerebellar artery (PICA) but not with that supplied by the SCA. However, the present patient, who had an infarct in the left SCA territory, displayed an executive dysfunction but no emotional disorder.
