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Akinetic Mutism and Cognitive-Affective Syndrome Caused by Unilateral PICA Infarction

Youngsoon Yang1, Jung Eun Kim, Jung Seok Lee

  • 1Department of Neurology, Seoul National University College of Medicine, Seoul, and Seoul National University Bundang Hospital, Gyeonggi-do, Korea.

Journal of Clinical Neurology (Seoul, Korea)
|June 11, 2009
PubMed

Insights

Posterior inferior cerebellar artery (PICA) infarction can cause akinetic mutism and cognitive deficits. This case highlights executive function impairments following a left PICA stroke, suggesting a link to cognitive-affective syndrome.

Area of Science:

  • Neurology
  • Neuroscience
  • Cerebrovascular Diseases

Background:

  • Posterior inferior cerebellar artery (PICA) infarction is a recognized cause of neurological deficits.
  • Akinetic mutism and cognitive impairment are potential sequelae of cerebellar strokes.
  • The specific impact of unilateral PICA infarction on executive functions requires further elucidation.

Purpose of the Study:

  • To describe a case of akinetic mutism and cognitive impairment following left PICA infarction.
  • To detail the neuropsychological findings, specifically executive function deficits.
  • To explore the potential association between unilateral PICA infarction and cognitive-affective syndrome.

Main Methods:

  • Case report of a 42-year-old male with left PICA infarction.
  • Clinical presentation including akinetic mutism and subsequent cognitive impairment.
  • Neuropsychological testing with age and education-corrected Korean norms to assess executive functions.

Main Results:

  • The patient initially presented with akinetic mutism post-left PICA infarction.
  • Neuropsychological evaluation revealed significant impairments in executive functions.
  • Specific deficits included difficulties with planning, abstract reasoning, set-shifting, and perseveration.

Conclusions:

  • Unilateral PICA infarction can manifest as akinetic mutism.
  • Executive dysfunction is a notable consequence of left PICA infarction.
  • Akinetic mutism and cognitive impairment may represent a cognitive-affective syndrome secondary to PICA stroke.
Keywords:
Akinetic mutismCognitive-affective syndromePICA

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