Cerebellar Mutism Syndrome in a Patient With Hypertensive Urgency and Ischemia: A Case Report

Cerebellar mutism syndrome (also known as posterior fossa syndrome) has been mostly seen in pediatric patients after surgery for neoplastic disease and is characterized by mutism, with variable symptoms such as emotional lability, ataxia, apraxia, and hypotonia. While the mechanism is not precisely defined, it is thought to result from disconnections between the cortical and cerebellar brain networks. Presentation in adult patients is rare, with various etiologies including posterior fossa ischemia, hemorrhage, and tumors being most reported. We report a case of adult-onset posterior fossa syndrome in a woman with a previous right hemisphere cerebellar stroke, in the context of contralateral cerebellar involvement and hypertensive urgency. The etiology, clinical presentation and course, and management of posterior fossa syndrome are discussed.