Maeshima Shinichiro, Osawa Aiko
Department of Rehabilitation Medicine, Kawasaki Medical School, Kawasaki Hospital, Japan.
Brain Inj. 2007 Jul;21(8):877-83. doi: 10.1080/02699050701504273.
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.
A case study.
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.
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.
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.
小脑在认知功能中发挥作用已变得显而易见，施马曼等人引入了“小脑认知情感综合征（CCAS）”这一术语。在本文中，我们报告了一名发生CCAS的小脑出血患者。
一项病例研究。
患者为一名61岁右利手男性，因突发头痛、头晕和呕吐入院。患者表现出躯干和四肢共济失调，但无瘫痪和感觉障碍。他存在时间定向障碍，表现出近期记忆障碍、注意力障碍、执行功能受损和意志减退，由于这些症状，他的日常生活也严重受损。
为了回家，患者接受了运动疗法和认知康复治疗，同时进行了家庭环境改造，从而能够在家人的照顾下居家生活。认知功能有所改善，但记忆和注意力障碍、执行功能受损仍然存在。
小脑损伤患者的认知功能障碍被认为是由大脑-小脑回路紊乱引起的，并且这些患者的康复不仅必须包括运动功能评估，还必须包括对脑功能的详细评估。
