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Updated: Aug 26, 2026

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Cerebellar cognitive affective syndrome (Schmahmann syndrome) following isolated cerebellar infarction
Mochamad Iskandarsyah Agung Ramadhan1, Diatri Nari Lastri1,2, Yetty Ramli1,2
1Universitas Indonesia, Faculty of Medicine, Department of Neurology, Jakarta, Indonesia.
Abstract:
The cerebellum plays an important role in higher-order cognition through cerebrocerebellar networks. Lesions affecting this structure may result in cerebellar cognitive affective syndrome (CCAS), which is frequently underrecognized by routine cognitive screening tools. We reported a 69-year-old right-handed man who presented with 18 months of forgetfulness, impaired concentration, and irritability following a documented left cerebellar infarction. Neurological examination revealed cerebellar signs without cortical deficits. Brain magnetic resonance imaging (MRI) demonstrated a left cerebellar infarct with hemorrhagic transformation. While the Mini-Mental State Examination (MMSE) was normal and the Montreal Cognitive Assessment (MoCA) showed mild impairment, detailed neuropsychological assessment using CCAS Scale (CCAS-S) confirmed definite CCAS. This case highlights the importance of cerebellum-specific cognitive assessment in patients with isolated cerebellar stroke, as conventional screening tools might underestimate multidomain cognitive and affective disturbances.
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