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Neuroanatomical Mechanism of Cerebellar Mutism After Stroke

Cerebellar mutism (CM) is a rare neurological condition characterized by lack of speech due to cerebellar lesions. CM is often reported in children. We describe a rare case of CM after spontaneous cerebellar hemorrhage. The patient showed mutism, irritability, decreased spontaneous movements and oro...

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Autores principales: Lee, Sekwang, Na, Yoon Hye, Moon, Hyun Im, Tae, Woo Suk, Pyun, Sung-Bom
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Academy of Rehabilitation Medicine 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5773428/
https://www.ncbi.nlm.nih.gov/pubmed/29354585
http://dx.doi.org/10.5535/arm.2017.41.6.1076
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author Lee, Sekwang
Na, Yoon Hye
Moon, Hyun Im
Tae, Woo Suk
Pyun, Sung-Bom
author_facet Lee, Sekwang
Na, Yoon Hye
Moon, Hyun Im
Tae, Woo Suk
Pyun, Sung-Bom
author_sort Lee, Sekwang
collection PubMed
description Cerebellar mutism (CM) is a rare neurological condition characterized by lack of speech due to cerebellar lesions. CM is often reported in children. We describe a rare case of CM after spontaneous cerebellar hemorrhage. The patient showed mutism, irritability, decreased spontaneous movements and oropharyngeal apraxia. Diffusion tensor imaging revealed significant volume reduction of medial frontal projection fibers from the corpus callosum. In Tracts Constrained by UnderLying Anatomy (TRACULA) analysis, forceps major and minor and bilateral cingulum-angular bundles were not visualized. Cerebello-frontal pathway reconstructed from the FMRIB Software Library showed continuity of fibers, with decreased number of fibers on qualitative analysis. These results suggest that cerebello-frontal disconnection may be a neuroanatomical mechanism of CM. Damage of brain network between occipital lobe, cingulate and cerebellum caused by hemorrhage may also have role in the mechanism of CM in our case.
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spelling pubmed-57734282018-01-21 Neuroanatomical Mechanism of Cerebellar Mutism After Stroke Lee, Sekwang Na, Yoon Hye Moon, Hyun Im Tae, Woo Suk Pyun, Sung-Bom Ann Rehabil Med Case Report Cerebellar mutism (CM) is a rare neurological condition characterized by lack of speech due to cerebellar lesions. CM is often reported in children. We describe a rare case of CM after spontaneous cerebellar hemorrhage. The patient showed mutism, irritability, decreased spontaneous movements and oropharyngeal apraxia. Diffusion tensor imaging revealed significant volume reduction of medial frontal projection fibers from the corpus callosum. In Tracts Constrained by UnderLying Anatomy (TRACULA) analysis, forceps major and minor and bilateral cingulum-angular bundles were not visualized. Cerebello-frontal pathway reconstructed from the FMRIB Software Library showed continuity of fibers, with decreased number of fibers on qualitative analysis. These results suggest that cerebello-frontal disconnection may be a neuroanatomical mechanism of CM. Damage of brain network between occipital lobe, cingulate and cerebellum caused by hemorrhage may also have role in the mechanism of CM in our case. Korean Academy of Rehabilitation Medicine 2017-12 2017-12-28 /pmc/articles/PMC5773428/ /pubmed/29354585 http://dx.doi.org/10.5535/arm.2017.41.6.1076 Text en Copyright © 2017 by Korean Academy of Rehabilitation Medicine http://creativecommons.org/licenses/by-nc/4.0 This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Lee, Sekwang
Na, Yoon Hye
Moon, Hyun Im
Tae, Woo Suk
Pyun, Sung-Bom
Neuroanatomical Mechanism of Cerebellar Mutism After Stroke
title Neuroanatomical Mechanism of Cerebellar Mutism After Stroke
title_full Neuroanatomical Mechanism of Cerebellar Mutism After Stroke
title_fullStr Neuroanatomical Mechanism of Cerebellar Mutism After Stroke
title_full_unstemmed Neuroanatomical Mechanism of Cerebellar Mutism After Stroke
title_short Neuroanatomical Mechanism of Cerebellar Mutism After Stroke
title_sort neuroanatomical mechanism of cerebellar mutism after stroke
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5773428/
https://www.ncbi.nlm.nih.gov/pubmed/29354585
http://dx.doi.org/10.5535/arm.2017.41.6.1076
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