• PNF and Movement
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• v.21 no.3
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• pp.327-335
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• 2023

Purpose: Cerebellar injury can be caused by a variety of factors, including trauma, stroke, and tumor. Cerebellar injury can manifest in different clinical symptoms and signs depending on the size and location of the injury. The purpose of this study was to examine and compare the recovery patterns of each motor function by tracking the motor levels of patients with cerebellar injury. Methods: This study recruited 11 patients with quadriplegia resulting from cerebellar injury. The motricity index (MI), modified Brunnstrom classification (MBC), and functional ambulation category (FAC) methods were used to evaluate motor levels. The motor function evaluation was performed immediately after the onset of the condition and at intervals of one month, two months, and six months after onset. Results: The MI values of the upper and lower extremities and hand function (MBC) indicated severe paralysis in the early stages of onset. Compared to the onset time, significant motor function recovery was observed after 1, 2, and 6 months (p < 0.05). In contrast, there was no significant pattern of recovery between 1, 2, and 6 months after onset (p > 0.05). FAC indicated showed significant recovery at one month compared to onset (p<0.05), and there was also a significant difference between 1 and 2 months (p < 0.05). On the other hand, there was no significant difference in FAC between 2 and 6 months (p > 0.05). Conclusion: Patients with cerebellar injury showed significant recovery in functions related to muscle strength and voluntary muscle control one month after onset and gradually recovered further over the next six months. On the other hand, gait function, which is closely related to balance, showed a relatively slow recovery pattern from the beginning of the disease to the six month follow-up.

• Journal of Korean Neurosurgical Society
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• v.50 no.6
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• pp.520-522
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• 2011

Injury to the vertebral artery during anterior cervical discectomy is rare but potentially fatal. We report a case of cerebellar infarction after endovascular embolization for iatrogenic vertebral artery injury at C5-C6 during an anterior cervical discectomy and fusion. A 61-year-old man had an intraoperative injury of the right vertebral artery that occurred during anterior cervical discectomy and fusion at C5-C6. Hemorrhage was not controlled successfully by packing with surgical hemostatic agents. While the patient was still intubated, an emergency angiogram was performed. The patient underwent endovascular occlusion of the right V2 segment with coils. After the procedure, his course was uneventful and he did not show any neurologic deficits. Brain computed tomographic scans taken 3 days after the operation revealed a right cerebellar infarction. Anti-coagulation medication was administered, and at 3-month follow-up examination, he had no neurologic sequelae in spite of the cerebellar infarction.

• Journal of Korean Neurosurgical Society
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• v.60 no.3
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• pp.367-370
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• 2017

Dural injury during spinal surgery can subsequently give rise to a remote cerebellar hemorrhage (RCH). Although the incidence of such injury is low, the resulting hemorrhage can be life threatening. The mechanism underlying the formation of the hemorrhage is not known, but it is mostly thought to develop after venous infarction. Cerebellar mutism (CM) is a frequent complication of posterior fossa operations in children, but it is rarely seen in adults. The development of CM after an RCH has not been described. We describe the case of a 65-year old female who lost cerebrospinal fluid after inadvertent opening of the dura during surgery. Computerized tomography performed when the patient became unable to speak revealed a bilateral cerebellar hemorrhage.

• PNF and Movement
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• v.14 no.2
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• pp.149-155
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• 2016

Purpose: The purpose of this study was to investigate the effects of using proprioceptive neuromuscular facilitation (PNF) exercise in the progressive sitting position on the dynamic balance ability of a patient with a cerebellar injury. Methods: The subject had ataxia due to cerebellar injury. The subject participated in a PNF bilateral scapular pattern exercise with stabilizing reversal technique during a progressive sitting position session as well as baseline for 20 minutes a day for 4 weeks. In the first session, PNF exercises were performed at a height of 40 cm for 10 minutes, and in the second session they were performed at 50 cm for 10 minutes from a lower center of gravity (COG) to a higher COG sitting position. We used the Berg Balance Scale (BBS), Five-Times-Sit-to-Stand Test (FTSST), and the Timed Up and Go Test (TUGT) to measure the subject's dynamic balance ability every two days through the entire session. Results: After participating in the program, the subject's dynamic balance ability improved compared to the first baseline, as measured by BBS (2 points increased), FTSST (5.3 sec decreased), and TUGT (2 sec decreased). The increase was also maintained in the second baseline session. Conclusion: PNF exercise using bilateral scapula patterns with a stabilizing reversal technique helps to enhance the dynamic balance ability of a cerebellar injury patient.

• The Journal of Korean Physical Therapy
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• v.16 no.2
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• pp.72-89
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• 2004

The purposes of this study were to test the effect of balance training and environmental enrichment on motor performance after traumatic cerebellar injury in the rat. Traumatic cerebellar injury was induced by weight drop model and after operation they were housed in individual standard cages for 24 hours. Twenty two Sprague-Dawley rats were randomly assigned into control and experimental groups. The control group was housed in standard cage for 7 days. The experimental group I was housed in standard cage after balance training for 7 days. The experimental group II was housed in environmental enrichment cage after balance training for 7 days. Vestibular drop test and tilting plane test was examined at preoperation, on 1st day after operation and 7th day after operation to the rats. The results of this experiment were as follows: 1. In motor behavioral test, at preoperation and on 1 day after operation, the outcomes were not different among the groups. But on 7th day after operation, the outcomes of group I were better than that in control group, and group II were better than group I. These results suggest that behavioral motor outcome by simultaneously application of balance training and environmental enrichment in traumatic cerebellar injured rats were more improve than that by just balance training.

• Journal of Korean Neurosurgical Society
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• v.53 no.2
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• pp.118-120
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• 2013

We report a rare case of remote cerebellar hemorrhage after intradural disc surgery at the L1-2 level. Two days after the spine surgery, patient complained unexpected headache, dizziness, nausea and vomiting. From the urgently conducted brain CT, it was reported that the patient had cerebellar hemorrhage. Occipital craniotomy and hematoma evacuation was performed, and hemorrhagic lesion on the right cerebellum was effectively removed. After occipital craniotomy, the patient showed signs of improvement on headache, dizziness, nausea and vomiting. He was able to leave the hospital after two weeks of initial operation without any neurological deficit. Remote cerebellar hemorrhage following spinal surgery is extremely rare, but may occur from dural damage of spinal surgery, accompanied with cerebrospinal fluid leakage. Early diagnosis is particularly important for the optimal treatment of remote cerebellar hemorrhage.

• Journal of International Academy of Physical Therapy Research
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• v.1 no.2
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• pp.91-98
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• 2010

This study is intended to examine the motor skill learning and treadmill exercise on motor performance and synaptic plasticity in the cerebellar injured rats by harmaline. Experiment groups were divided into four groups and assigned 15 rats to each group. Group I was a normal control group(induced by saline); Group II was a experimental control group(cerebellar injured by harmaline); Group III was a group of motor skill learning after cerebellar injured by harmaline; Group IV was a group of treadmill exercise after cerebellar injured by harmaline. In motor performance test, the outcome of group II was significantly lower than the group III, IV(especially group III)(p<.001). In histological finding, the experimental groups were destroy of dendrities and nucleus of cerebellar neurons. Group III, IV were decreased in degeneration of cerebellar neurons(especially group III). In immunohistochemistric response of synaptophysin in cerebellar cortex, experimental groups were decreased than group I. Group III's expression of synaptophysin was more increased than group II, IV. In electron microscopy finding, the experimental groups were degenerated of Purkinje cell. These result suggest that improved motor performance by motor skill learning after harmaline induced is associated with dynamically altered expression of synaptophysin in cerebellar cortex and that is related with synaptic plasticity.

• Journal of the Korean Society of Physical Medicine
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• v.5 no.3
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• pp.455-465
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• 2010

Purpose : This study is intended to examine the motor skill learning on balance and coordination in the cerebellar injured rats by 3AP. Methods : This study selected 60 Sprague-Dawley rats of 8 weeks. Experiment groups were divided into four groups and assigned 15 rats to each group. Group I was a normal control group(induced by saline); Group II was a experimental control group(cerebellar injured by 3AP); Group III was a group of motor skill learning after cerebellar injured by 3AP; Group IV was a group of treadmill exercise after cerebellar injured by 3AP. In each group, motor performance test, histologic observations, synaptophysin expression and electron microscopy observation were analyzed. Results : In motor performance test, the outcome of group II was significantly lower than the group III, IV(especially group III)(p<.001). In histological finding, the experimental groups were destroy of dendrities and nucleus of cerebellar neurons. Group III, IV were decreased in degeneration of cerebellar neurons(especially group III). In immunohistochemistric response of synaptophysin in cerebellar cortex, experimental groups were decreased than group I. Group III's expression of synaptophysin was more increased than group II, IV. In electron microscopy finding, the experimental groups were degenerated of Purkinje cell. Conclusion : These result suggest that improved motor performance by motor skill learning after harmaline induced is associated with dynamically altered expression of synaptophysin in cerebellar cortex and that is related with synaptic plasticity.

• Journal of Korean Neurosurgical Society
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• v.44 no.4
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• pp.205-210
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• 2008

Objective : Aneurysms are very rarely encountered in the distal posterior inferior cerebellar artery (PICA). The authors experienced 5 cases with a distal PICA aneurysm among 368 cases of intracranial aneurysms during the period from January 2003 to January 2008. Here, the authors describe their clinical and surgical experiences and include a review of the relevant literature. Methods : Using radiologic findings and charts, we retrospectively reviewed the surgical results of 5 cases with a distal PICA aneurysm treated from January 2003 to January 2008. Results : The current five cases were composed of four cases of 'Good' and one case of 'Fair'. No postoperative complications occurred other than a ventriculo-peritoneal shunt due to hydrocephalus in Case 2. In all five cases, treatment was successful without neurological deficit. Conclusion : Surgical outcome of PICA aneurysms have been reported to be excellent because the amount of intraparenchymal injury is limited. More clinical experience, microsurgical technique developments, and endovascular surgery advancements are certain to improve treatment outcomes.

• Journal of Korean Neurosurgical Society
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• v.29 no.3
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• pp.407-410
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• 2000

The traumatically induced mass lesions of the posterior cranial fossa are unusual. Various types of traumatic posterior fossa hematoma have been described ; the most common forms is epidural hematomas, and frequently traumatic intracerebellar hemorrhage is encountered. A sixty-six-old male patient was initially presented with the occipital skull fracture and contusional hemorrhage on the both frontal lobe, a developed delayed cerebellar hemorrhage. The patient was operated for hematoma removal with good postoperative recovery. We advise a consideration for delayed intracerebellar hematoma in patients with cerebellar contusion following trauma.