Cognitive function disorders in cerebellum stroke versus crossed diaschisis – case report

Kliniczny Oddział Neurologiczny, Szpital Bielański im. ks. J. Popiełuszki w Warszawie. Ordynator: prof. dr hab. n. med. Jan Kochanowski

AKTUALN NEUROL 2011, 11 (1), p. 18-22

Cerebellum coordinates skilled voluntary movements, and controls motor tone, posture and gain. However, anatomical, clinical, and neuroimaging studies conducted over the past decades have shown that the cerebellum is implicated in diverse higher cognitive functions, such as language, memory, visuospatial skills, executive functions and emotional regulation of behaviour. Anatomy and functional magnetic imaging studies indicate a link between right cerebellum and the left frontal regions. Crossed cerebello-cerebral diaschisis, reflecting a functional depression of supratentorial areas due to reduced input via cerebello-cortical pathways, may represent the neuropathological mechanism responsible for cognitive and speech deficits associated with cerebellar pathology. Damage to the cerebello-cortical loop brings about comportments that resemble those of injury to the cerebral cortical areas subserved by that loop. Rather than generating cognitive processes, the cerebellum is considered to modulate cognitive functions through the feed-forward loop of the cortico-ponto-cerebellar system and the feedback loop of the cerebello-thalamo-cortical pathways. The authors present 58 years old patient with a hemorrhagic stroke in the right cerebellar hemisphere with cognitive impairment in domains of memory, language and speech and attention.

Keywords: cerebellum, stroke, cognitive function, speech, crossed cerebello-cerebral diaschisis