J Clin Neurol.  2007 Dec;3(4):192-196. 10.3988/jcn.2007.3.4.192.

Akinetic Mutism and Cognitive-Affective Syndrome Caused by Unilateral PICA Infarction

• Yang Y
• Kim JE
• Lee JS
• Kim S

• KMID: 1808554
• DOI: http://doi.org/10.3988/jcn.2007.3.4.192

Abstract

A 42-year-old man with left posterior inferior cerebellar artery (PICA) infarction presented with akinetic mutism and cognitive impairment. Initially he suffered from akinetic mutism and MRI-documented infarction in the distribution of the left PICA. Twelve days later he developed cognitive impairment. Neuropsychological tests were performed, with the results corrected for age and education being compared with published Korean norms. Impaired performances were evident on executive function testing, with difficulties in planning, abstract reasoning, set-shifting, and perseveration. Akinetic mutism and cognitive-affective syndrome may be a manifestation of unilateral PICA infarction.

Keyword

Akinetic mutism; PICA; Cognitive-affective syndrome

MeSH Terms

Adult
Akinetic Mutism*
Arteries
Education
Executive Function
Humans
Infarction*
Neuropsychological Tests
Pica*

Figure

• 

  Figure 1 (A) Diffusion-weighted magnetic resonance imaging and fluid attenuated inversion recovery scans of the brain at presentation, showing a high signal in the left PICA. (B) Magnetic resonance angiography scan of the brain at presentation, showing normal findings.

• 

  Figure 2 Brain single-photon-emission computed tomography at presentation, showing hypoperfusion in the left cerebellar and frontal cortex.

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