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Visual Neglect after PICA Stroke—A Case Study
After cerebellar stroke, cognition can be impaired, as described within the framework of the so-called Cerebellar Cognitive Affective Syndrome (CCAS). However, it remains unclear whether visual neglect can also be part of CCAS. We describe the case of a patient with a subacute cerebellar stroke afte...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8869876/ https://www.ncbi.nlm.nih.gov/pubmed/35204053 http://dx.doi.org/10.3390/brainsci12020290 |
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author | Geiser, Nora Kaufmann, Brigitte Charlotte Rühe, Henrik Maaijwee, Noortje Nef, Tobias Cazzoli, Dario Nyffeler, Thomas |
author_facet | Geiser, Nora Kaufmann, Brigitte Charlotte Rühe, Henrik Maaijwee, Noortje Nef, Tobias Cazzoli, Dario Nyffeler, Thomas |
author_sort | Geiser, Nora |
collection | PubMed |
description | After cerebellar stroke, cognition can be impaired, as described within the framework of the so-called Cerebellar Cognitive Affective Syndrome (CCAS). However, it remains unclear whether visual neglect can also be part of CCAS. We describe the case of a patient with a subacute cerebellar stroke after thrombosis of the left posterior inferior cerebellar artery (PICA), who showed a left-sided visual neglect, indicating that the cerebellum also has a modulatory function on visual attention. The neglect, however, was mild and only detectable when using the sensitive neuro-psychological Five-Point Test as well as video-oculography assessment, yet remained unnoticed when evaluated with common neglect-specific paper-pencil tests. Three weeks later, follow-up assessments revealed an amelioration of neglect symptoms. Therefore, these findings suggest that visual neglect may be a part of CCAS, but that the choice of neglect assessments and the time delay since stroke onset may be crucial. Although the exact underlying pathophysiological mechanisms remain unclear, we propose cerebellar–cerebral diaschisis as a possible explanation of why neglect can occur on the ipsilateral side. Further research applying sensitive assessment tools at different post-stroke stages is needed to investigate the incidence, lesion correlates, and pathophysiology of neglect after cerebellar lesions. |
format | Online Article Text |
id | pubmed-8869876 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-88698762022-02-25 Visual Neglect after PICA Stroke—A Case Study Geiser, Nora Kaufmann, Brigitte Charlotte Rühe, Henrik Maaijwee, Noortje Nef, Tobias Cazzoli, Dario Nyffeler, Thomas Brain Sci Case Report After cerebellar stroke, cognition can be impaired, as described within the framework of the so-called Cerebellar Cognitive Affective Syndrome (CCAS). However, it remains unclear whether visual neglect can also be part of CCAS. We describe the case of a patient with a subacute cerebellar stroke after thrombosis of the left posterior inferior cerebellar artery (PICA), who showed a left-sided visual neglect, indicating that the cerebellum also has a modulatory function on visual attention. The neglect, however, was mild and only detectable when using the sensitive neuro-psychological Five-Point Test as well as video-oculography assessment, yet remained unnoticed when evaluated with common neglect-specific paper-pencil tests. Three weeks later, follow-up assessments revealed an amelioration of neglect symptoms. Therefore, these findings suggest that visual neglect may be a part of CCAS, but that the choice of neglect assessments and the time delay since stroke onset may be crucial. Although the exact underlying pathophysiological mechanisms remain unclear, we propose cerebellar–cerebral diaschisis as a possible explanation of why neglect can occur on the ipsilateral side. Further research applying sensitive assessment tools at different post-stroke stages is needed to investigate the incidence, lesion correlates, and pathophysiology of neglect after cerebellar lesions. MDPI 2022-02-19 /pmc/articles/PMC8869876/ /pubmed/35204053 http://dx.doi.org/10.3390/brainsci12020290 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Case Report Geiser, Nora Kaufmann, Brigitte Charlotte Rühe, Henrik Maaijwee, Noortje Nef, Tobias Cazzoli, Dario Nyffeler, Thomas Visual Neglect after PICA Stroke—A Case Study |
title | Visual Neglect after PICA Stroke—A Case Study |
title_full | Visual Neglect after PICA Stroke—A Case Study |
title_fullStr | Visual Neglect after PICA Stroke—A Case Study |
title_full_unstemmed | Visual Neglect after PICA Stroke—A Case Study |
title_short | Visual Neglect after PICA Stroke—A Case Study |
title_sort | visual neglect after pica stroke—a case study |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8869876/ https://www.ncbi.nlm.nih.gov/pubmed/35204053 http://dx.doi.org/10.3390/brainsci12020290 |
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