Disclosures: Jessica V. Marone, MD: No financial relationships or conflicts of interest

Case Diagnosis: 73-year-old right-hand dominant woman with right cerebellar hemorrhagic stroke

Case Description or Program Description: The patient presented to acute care with a severe headache and vomiting. Imaging demonstrated a right cerebellar hemorrhagic stroke with extension into the third, fourth, and lateral ventricles. There was no evidence of stroke involvement in the cortical structures. The patient was discharged to acute inpatient rehabilitation where she was noted to have severe language impairments that were best characterized as Wernicke’s-type aphasia. Only mild dysarthria was noted, and there was no evidence of verbal apraxia. At evaluation, she was noted to require maximal-assistance for comprehension and verbal expression and scored 5 out of 15 on the Boston Naming Test.

Setting: Acute Inpatient Rehabilitation

Assessment/Results: After participating in four weeks of intensive cognitive, speech, and language therapy, the patient’s comprehension improved to minimal-assistance level and her expression improved to moderate-assistance level. Dysarthria resolved, but re-evaluation of the Boston Naming Test remained at 5 out of 15. The patient was recommended to continue in outpatient therapy to target her language impairments.

Discussion (relevance): Aphasia is typically associated with lesions in the cerebral cortex. Here, we present the case of a patient with a cerebellar stroke predominantly limited by Wernicke’s-type aphasia. The cerebellum is classically thought to play a role in voluntary movement, gait, motor coordination, and speech. However emerging evidence suggests that the cerebellum may also play a role in language processing and production, corresponding to our patient’s impairments.

Conclusions: In this report, we intend to make the clinician aware that patients with cerebellar strokes may present with impairments in language domains. Recognition of this stroke syndrome is critical to ensuring that language impairments are addressed and targeted appropriately in the rehab setting.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/a-patient-with-cerebellar-stroke-and-aphasia-a-case-report/