Injury

Question 1

What is a hallmark of unilateral cerebellar hemisphere leision?

Answer 1

Ipsilateral loss of motor coordination

Question 2

Hallmark of unilateral UMN (Corticospinal/corticobrainstem tract) lesion is?

Answer 2

contralateral loss of voluntary muscle contraction

Question 3

Cerebellar injuries result in?

Answer 3

Ataxia

Question 4

What is ataxia?

Answer 4

uncoordinated movements

Question 5

Corticospinal tract/corticobrainstem tract injuries result in?

Answer 5

paresis/paraylsis

Question 6

T/F

Injury to input/outputs can mimic an injury to the cerebellum itself?

Answer 6

T

Question 7

T/F

Cerebellar injury may see injuries to a single longitudinal zone (vermis, paravermis, lateral hemisphere) but more often see injuires to the vestibulocerbellum, hemisphere (paravermis + lateral hemisphere) and/or to the body (body = vermis + hemisphere)

Answer 7

T

Question 8

What happens with vestibulocerebellum injuries - general loss of?

Answer 8

equilibrium, which causes vertigo, dizziness and imbalance

Question 9

What happens with a loss of equilibrium?

Answer 9

wide-based staggering gait

tend to fall over - often toward side of lesion

Question 10

What happens with vestibulocerebellum injuries - rhythmic eye movements with a fast and slow component in opposite directions that is a drift from the target then jump back is called?

Answer 10

nystagmus

Question 11

What happens with vestibulocerebellum and vermis injuries - gaze stabilization and?

Answer 11

eye tracking difficulties

Question 12

What happens with vestibulocerebellum and vermis injuries - abnormal saccades and?

Answer 12

smooth pursuit movements

Question 13

What happens with vestibulocerebellum and vermis injuries - what has the following?

1) difficulty maintaining standing or sitting balance without support
2) sway when standing
3) Leads to ataxia of gait due to truncal instability

Answer 13

truncal ataxia (titubation)

Question 14

What causes?

• flattened affect
• Acquired panic disorder
• Paranoia
• disinhibition
• flamboyancy
• impulsiveness
• irritability
• emotional lability
• loss of empathy

Answer 14

impaired affective regulation

Limbic cerebellum - posterior vermis

Question 15

Hemisphere injuries - what causes?

• trouble with walking, gait initiation, stopping and turning
• Impaired tandem gait
• Due to impaired LE coordination
• Also seen with vestibulocerebellum and vermis injuries due to truncal imbalance

Answer 15

Gait ataxia

Question 16

Hemisphere injuries - limb ataxia is?

Answer 16

ipsilateral

Question 17

Hemisphere injuries - limb ataxia is a result of injury to?

Answer 17

either part of the cerebellar hemisphere (paravermis or lateral hemisphere)

Question 18

Hemisphere injuries - limb ataxia what needs to be involved for finger/thumb ataxia?

Answer 18

lateral hemisphere

Question 19

Also of note that limb ataxia can also be from peripheral neuropathy or other cerebral injuries affecting cerebellar?

Answer 19

input/output

Question 20

Hemisphere injuries - limb ataxia what is caused by?

• inability to do rapid, alternating movements (pronation/supination, finger flexion/extension)
• Rapid, alternating movements look slow and uncoordinated
• Delayed cessation of agonist at turning point

Answer 20

Dysdiadochokinesis/dysdiadochokinesia

Question 21

Hemisphere injuries - limb ataxia what is caused by?

• inability to move an intended distance
• hypermetria
• hypometria

Answer 21

Dysmetria

Question 22

overshoot a target is called?

Answer 22

hypermetria

Question 23

undershoot a target is called?

Answer 23

hypometria

Question 24

Hemisphere injuries - limb ataxia what is caused by?

• Robotic-like movement
• May be compensatory for the limb ataxia rather than an actual component of the ataxia

Answer 24

Movement - decomposition

Question 25

Paravermis/Medial hemisphere injuries - ataxia dysarthria

-What is difficulty with rapid succession of lip, tongue and soft palate movements?

Answer 25

Dysdiadochokinesia of speech

Question 26

Lateral hemisphere injuries impairment with?

Answer 26

language

• linguistic deficits
• Reduced verbal fluency and ability to understand metaphors and ambiguity

Question 27

Lateral hemisphere injuries have what kind of impairments?

Answer 27

Cognitive - impaired executive functioning
Impaired working memory and learning
Impaired spatial relations and ability to judge distances

Question 28

Examples of executive funtioning?

Answer 28

concrete thinking
poor problem solving strategies
impaired ability to multitask
trouble planning and organizing

Question 29

Other cerebellar signs/symptoms are what and caused by?

• involuntary oscillation during voluntary movement
• Worsens as approach target
• Large amplitude and lower frequency, non-rhythmic

-Affects 50% of patients with cerebellar injuries

Answer 29

Tremors - intention/action tremors

Question 30

Other cerebellar signs/symptoms - Tremors that are?
Proximal muscles > distal
Seen when holding a static position against gravity

Answer 30

Postural

Question 31

Other cerebellar signs/symptoms - Tremors that are?

Occurs at the start of a movement?

Answer 31

Kinetic

Question 32

Other cerebellar signs/symptoms - What kind may also be related to the cerebellum?

Answer 32

Essential tremors - causes involuntary and rhythmic shaking (grandpa)

Question 33

Other cerebellar signs/symptoms - What causes?

• Acute extensive injuries of the cerebellum
• Most pronounced in the UEs
• Tends to normalize after weeks to months

Answer 33

Transient hypotonia

Question 34

Other cerebellar signs/symptoms - What causes?

• Increased time to develop a stable grasp
• Altered aperture for grasp
• Exaggerated grip force
• Likely both paravermis and lateral hemisphere involved

Answer 34

Grasp deficits

Question 35

Other cerebellar signs/symptoms - What causes?

• Used to believe there was no sensory impairments
• Now believe that there may be impairment in awareness of force, duration or velocity of movement

Answer 35

Sensory impairments