病例联合讨论会100-09-21精选.ppt

Cerebellar Anatomy A:?Midbrain B:?Pons C:?Medulla D:?Spinal cord E:?Fourth ventricle F:?Arbor vitae G:?Tonsil. H: Anterior lobe. I: Posterior lobe. /wiki/Anatomy_of_the_cerebellum /wiki/Anatomy_of_the_cerebellum The cerebellar motor syndrome results when lesions involve the anterior lobe and parts of lobule VI, interrupting cerebellar communication with cerebral and spinal motor systems. Cognitive impairments occur when posterior lobe lesions affect lobules VI and VII (including Crus I, Crus II, and lobule VIIB), disrupting cerebellar modulation of cognitive loops with cerebral association cortices. Neuropsychiatric disorders manifest when vermis lesions deprive cerebrocerebellar limbic loops of cerebellar input. Having infarcts in 1 location is associated with poor performance in memory, processing speed, and executive function, independent of cardiovascular comorbidities, white matter lesions, and brain atrophy, suggesting that both the number and the distribution of infarcts jointly contribute to cognitive impairment. (Stroke. 2009;40:677-682.) Ataxia is a movement disorder resulting from the incoordination of movements and inadequate postural control, presented in balance and walking disturbances. It has three subcategories, which are sensory, cerebellar and vestibular ataxia. Some researchers regard frontal ataxia as the 4th category. Mixed ataxia involves symptoms of at least two basic types of ataxia together. Different clinical symptoms, interference of different neurological structures and different diseases play role in the formation of each ataxia type. Since ataxia is resistant to medical treatments, physical treatment applications are of major importance. Physical therapy applications involve proprioceptive training, balance exercises, stabilization techniques regarding the extremity ataxia and vestibular exercises for accomplishing functional improvement and restoration of the ataxic patient. Compensatory applications employ supportive devic