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Abstract：
Cognitive impairment in focal cerebellar disorders has been widely recognized and is described as cerebellar cognitive affective syndrome (CCAS). However, the relationship between CCAS and crossed cerebello-cerebral diaschisis (CCD) has rarely been discussed. The present report describes the uncommon phenomenon of CCD in two cases with isolated cerebellar infarction, and discuss its contribution to cognitive impairment. Cognitive performance was examined using the CCAS scale and a battery of neuropsychological assessments. Moreover, the relative distribution of cerebral and cerebellar blood flow was measured using three-dimensional arterial spin labeling imaging. Case 1 showed deficits in general cognition and had impaired language, episodic memory, and executive function. Case 2 showed deficits in general cognition at baseline, and cognitive deterioration of visuospatial abilities, language, episodic memory, and executive function was observed at the 3-month follow-up. Both cases met the diagnosis criteria of CCAS. Reduced cerebral blood flow was observed in the cerebral hemisphere contralateral to the cerebellar infarction at baseline in Case 1, and at the 3-month follow-up in Case 2. The present report describes cognitive decline after isolated cerebellar infarction in combination with contralateral cerebral hypoperfusion, as measured using quantitative arterial spin labeling. One possible mechanism involves the functional depression of cerebello-cerebral pathways.
摘要：
局灶性小脑疾病中的认知障碍已得到广泛认可，并被描述为小脑认知情感综合征（CCAS）。然而,CCAS与小脑横断（CCD）之间的关系很少被讨论。本报告描述了两种孤立性小脑梗死病例中CCD的罕见现象，并讨论其对认知障碍的贡献。使用CCAS量表和一系列神经心理学评估来检查认知表现。此外，使用三维动脉自旋标记成像测量脑和小脑血流量的相对分布。病例1显示一般认知缺陷，语言障碍，情景记忆,和执行功能。病例2显示基线时的一般认知缺陷，和视觉空间能力的认知退化，语言,情景记忆,在3个月随访时观察到执行功能。2例均符合CCAS诊断标准。在病例1的基线和病例2的3个月随访时，在小脑梗死对侧的大脑半球观察到脑血流量减少。本报告描述了孤立性小脑梗死合并对侧脑灌注不足后的认知下降，使用定量动脉自旋标记测量。一种可能的机制涉及小脑-大脑通路的功能性抑制。
