Brain injury · 2025
Markedly restricted life space due to long-term persistence of cerebellar cognitive affective syndrome following cerebellar hemorrhage: a case report.
СтатьяКлинический случайНазвание и аннотация: Перевод в очереди
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Shinya Tokuaki, Tanaka Shota, Yamauchi Kota, Arakawa Shuji
Аннотация
BACKGROUND: The long-term effects of Cerebellar Cognitive Affective Syndrome (CCAS) after cerebellar stroke on daily life remain unclear. Life space, evaluated using Life Space Assessment (LSA), reflects mobility, social participation, and independence, providing real-world insight into CCAS.
CASE DESCRIPTION: We report the case of a 68-year-old Japanese woman with normal premorbid cognition and independence who underwent emergent craniotomy for a right cerebellar hemorrhage involving lobules VII - VIII and the dentate nucleus. Initially, the patient exhibited severe ataxia (Scale for the Assessment and Rating of Ataxia (SARA) 22.5), inability to walk (Functional Ambulation Category (FAC) 0), and cognitive deficits (Mini Mental State Examination (MMSE) 23; CCAS-Scale 50) with anosognosia and reduced speech coherence. After 2 months, motor function improved (SARA 7, FAC 4), allowing discharge, though executive and attentional deficits persisted despite MMSE improving to 27. Three years later, motor recovery was nearly complete (SARA 2.5, FAC 5) with preserved independence in activities of daily living. However, neuropsychological impairment remained (Trail Making Test-B 330 s; CCAS-Scale 75, categorized definite CCAS). LSA decreased from 92 prehemorrhage to 39, indicating marked restriction beyond the neighborhood.
CONCLUSIONS: This case highlights that CCAS can impose long-term life-space limitation despite excellent motor recovery.
CASE DESCRIPTION: We report the case of a 68-year-old Japanese woman with normal premorbid cognition and independence who underwent emergent craniotomy for a right cerebellar hemorrhage involving lobules VII - VIII and the dentate nucleus. Initially, the patient exhibited severe ataxia (Scale for the Assessment and Rating of Ataxia (SARA) 22.5), inability to walk (Functional Ambulation Category (FAC) 0), and cognitive deficits (Mini Mental State Examination (MMSE) 23; CCAS-Scale 50) with anosognosia and reduced speech coherence. After 2 months, motor function improved (SARA 7, FAC 4), allowing discharge, though executive and attentional deficits persisted despite MMSE improving to 27. Three years later, motor recovery was nearly complete (SARA 2.5, FAC 5) with preserved independence in activities of daily living. However, neuropsychological impairment remained (Trail Making Test-B 330 s; CCAS-Scale 75, categorized definite CCAS). LSA decreased from 92 prehemorrhage to 39, indicating marked restriction beyond the neighborhood.
CONCLUSIONS: This case highlights that CCAS can impose long-term life-space limitation despite excellent motor recovery.