Case Report: The Forgotten Functions of the Hindbrain
Shalina Ramsewak, Shruti Lodhi

TL;DR
This case report shows how damage to the cerebellum can cause cognitive and emotional issues, highlighting the often-overlooked role of the hindbrain in cognition.
Contribution
The paper emphasizes the underappreciated cognitive functions of the cerebellum and the importance of recognizing Cerebellar Cognitive Affective Syndrome (CCAS).
Findings
A cerebellar infarct was linked to cognitive and emotional symptoms consistent with CCAS.
CCAS involves disruptions in neural circuits connecting the cerebellum with the cerebrum.
The case suggests that CCAS is underdiagnosed due to lack of awareness of cerebellar cognitive functions.
Abstract
Aims: This case highlights the cognitive functions of the cerebellum which is often forgotten about. Methods: An 80-year-old lady with a previous mental health diagnosis of Bipolar Affective disorder (BIPAD). She presented to the general hospital in July 2024 with a sudden onset of confusion and aggressive behaviour. She was referred to the Psychiatric Liaison Service (PLS). On assessments, she presented with no clear mood or psychotic disorder suggestive of relapse in her BIPAD. She scored 8 out 30 on the Mini-Addenbrooke’s Cognitive Examination (M-ACE) – losing marks on attention, memory – registration/recall, verbal fluency and the clock drawing test showed neglect. She lacked insight into her presentation and thus was in hospital under Deprivation of Liberty Safeguards (DoLS). Collateral history from her son corroborated that this was not a relapse in BIPAD. He enquired about an…
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Taxonomy
TopicsVestibular and auditory disorders
