Neuroanatomical Mechanism of Cerebellar Mutism After Stroke.
10.5535/arm.2017.41.6.1076
- Author:
Sekwang LEE
1
;
Yoon Hye NA
;
Hyun Im MOON
;
Woo Suk TAE
;
Sung Bom PYUN
Author Information
1. Department of Physical Medicine and Rehabilitation, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea. rmpyun@korea.ac.kr
- Publication Type:Case Report
- Keywords:
Akinetic mutism;
Cerebellum;
Diffusion tensor imaging
- MeSH:
Akinetic Mutism;
Apraxias;
Brain;
Cerebellum;
Child;
Corpus Callosum;
Diffusion Tensor Imaging;
Hemorrhage;
Humans;
Mutism*;
Occipital Lobe;
Stroke*;
Surgical Instruments
- From:Annals of Rehabilitation Medicine
2017;41(6):1076-1081
- CountryRepublic of Korea
- Language:English
-
Abstract:
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.
