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CC BY-NC-ND 4.0 · Indian Journal of Neurotrauma 2022; 19(01): 040-043
DOI: 10.1055/s-0041-1727294
Case Report

Neuropsychological and Linguistic Outcomes after Gunshot Injury to Cerebellum: A Case Report

Mohammed Afsar
1   Department of Clinical Psychology, National Institute of Mental Health and Neuro-Sciences, Bangalore, Karnataka, India
,
Kamasetru Jeevendrakumar Darshini
2   Department of Speech Pathology and Audiology, National Institute of Mental Health and Neuro-Sciences, Bangalore, Karnataka, India
,
Dhaval Shukla
3   Department of Neurosurgery, National Institute of Mental Health and Neuro-Sciences, Bangalore, Karnataka, India
,
Valiyaparambath Vandana
2   Department of Speech Pathology and Audiology, National Institute of Mental Health and Neuro-Sciences, Bangalore, Karnataka, India
,
Jamuna Rajeswaran
1   Department of Clinical Psychology, National Institute of Mental Health and Neuro-Sciences, Bangalore, Karnataka, India
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Abstract

Craniocerebral gunshot injuries (CGIs) are highly fatal and mostly seen in the military settings. CGIs to the posterior cortical regions and cerebellum in civilian population are uncommon. Cerebellum once thought to be mediating the motor and vestibular functions is increasingly seen as an important structure for human cognition and affect. We present a case of a 53-year-old police inspector who sustained a gunshot injury in the suboccipital region with resulting damage to predominantly left cerebellum and right occipital lobe. Patient presented with complaints of neck pain, reduced clarity of speech, and mild forgetfulness for day-to-day affairs after 7 months of injury. A comprehensive neuropsychological assessment revealed impairments in motor speed, processing speed, sustained attention, executive functions (verbal fluency, working memory), and encoding component of memory functions. The speech–language assessment revealed mild dysarthria and mild word finding difficulties. His profile with mild to moderate deficits in neuropsychological and speech language functioning was partly congruent with the cerebellar cognitive affective syndrome or Schmahmann’s syndrome. The spontaneous recovery and extent of damage to cerebellum may explain the milder form of the syndrome. The case highlights the need to routinely screen for cognitive-affective disturbances in patients with traumatic lesions to cerebellum.

Keywords

gunshot injury - brain injury - cerebellar cognitive affective syndrome - cerebellum - neuropsychological impairments


Publication History

Article published online:
15 April 2021

© 2021. Neurotrauma Society of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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