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...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-02-01
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| Series: | Brain Sciences |
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| Online Access: | https://www.mdpi.com/2076-3425/12/2/290 |
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| author | Nora Geiser Brigitte Charlotte Kaufmann Henrik Rühe Noortje Maaijwee Tobias Nef Dario Cazzoli Thomas Nyffeler |
| author_facet | Nora Geiser Brigitte Charlotte Kaufmann Henrik Rühe Noortje Maaijwee Tobias Nef Dario Cazzoli Thomas Nyffeler |
| author_sort | Nora Geiser |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-03-09T22:27:35Z |
| format | Article |
| id | doaj.art-fe317f55e5174e3fb2a33a54861e9972 |
| institution | Directory Open Access Journal |
| issn | 2076-3425 |
| language | English |
| last_indexed | 2024-03-09T22:27:35Z |
| publishDate | 2022-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Brain Sciences |
| spelling | doaj.art-fe317f55e5174e3fb2a33a54861e99722023-11-23T19:04:35ZengMDPI AGBrain Sciences2076-34252022-02-0112229010.3390/brainsci12020290Visual Neglect after PICA Stroke—A Case StudyNora Geiser0Brigitte Charlotte Kaufmann1Henrik Rühe2Noortje Maaijwee3Tobias Nef4Dario Cazzoli5Thomas Nyffeler6Neurocenter, Luzerner Kantonsspital, 6000 Lucerne, SwitzerlandNeurocenter, Luzerner Kantonsspital, 6000 Lucerne, SwitzerlandNeurocenter, Luzerner Kantonsspital, 6000 Lucerne, SwitzerlandNeurocenter, Luzerner Kantonsspital, 6000 Lucerne, SwitzerlandARTORG Center for Biomedical Engineering Research, University of Bern, 3008 Bern, SwitzerlandNeurocenter, Luzerner Kantonsspital, 6000 Lucerne, SwitzerlandNeurocenter, Luzerner Kantonsspital, 6000 Lucerne, SwitzerlandAfter 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.https://www.mdpi.com/2076-3425/12/2/290neglectPICAvideo-oculographyfree visual explorationstroke |
| spellingShingle | Nora Geiser Brigitte Charlotte Kaufmann Henrik Rühe Noortje Maaijwee Tobias Nef Dario Cazzoli Thomas Nyffeler Visual Neglect after PICA Stroke—A Case Study Brain Sciences neglect PICA video-oculography free visual exploration stroke |
| 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 | neglect PICA video-oculography free visual exploration stroke |
| url | https://www.mdpi.com/2076-3425/12/2/290 |
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