164 Dementia Japan 25 : 164-169, 2011 Mini - mental state examination 36 30 83.3% Raven s colored progressive matrices 31 20 64.5% Frontal assessment battery 34 26 76.5% Shinichiro Maeshima 1, Aiko Osawa 1, Hiroshi Matsuda 2, Yasuhiro Miyazaki 1, Fumitaka Yamane 3, Shoichiro Ishihawa 3, Hiroki Kurita 4, Aikira Satoh 4, Norio Tanahashi 5 1 2 3 4 5 350-1298 1397-1 1 Department of Rehabilitation Medicine, 2 Department of Nuclear Medicine, 3 Department of Endovascular Neurosurgery, 4 Department of Cerebrovascular Neurosurgery, 5 Department of Neurology, Saitama Medical University International Medical Center 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan 10% 2008 Fisher, 1965 Schmahmann et al., 1998 ; 2008 Maeshima et al., 2007 739
165 54 36 36 95 70.5±11.0 21 15 34 2 6 16 11.3±2.5 0 7 1.4±1.6 6.8±6.8 22.4±14.0 32 4 32 4 2 3D - CTA 1 1 Mini - mental state examination MMSE Raven s colored progressive matrices RCPM Frontal assessment battery FAB MMSE 30 Folstein et al., 1975 RCPM 6 36 Raven, 1976 FAB GO - NO - GO 6 3 18 Dubois et al., 2000 2006 MMSE 23/24 RCPM 24/25 FAB 12/13 CT 1/6 π A B C A, B, C : 1985 24 Single photon emission CT SPECT 99mTc - ECD technetium - 99m L, L - ethyl cysteinate dimer 600 MBq Patlak Plot Matsuda et al., 1995 SPECT 2 SPECT/CT symbia T6 ESOFTP LEHR SPECT 3.3 mm 128 128 CT PC Matlab Mathworks Statistical Parametric Mapping SPM8, http://www.fil.ion.ucl.ac.uk/spm/ spatial normalization smoothing ANCOVA p<0.05, size in voxels>200 JMP 8.02 χ 2 5% 3 23 5 10 0.9 90.6 ml 17.7±20.5 ml 33 19 14 MMSE 36 30 83.3% RCPM 31 20 64.5% FAB 34 26 76.5% 1
166 Dementia Japan Vol. 25 No. 2 September 2011 図 1. 各種認知機能検査と血腫量, 血腫部位の関係 図 2. 各種認知機能検査での異常と関連がみられた局所脳血流の低下部位 2
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169 Cognitive dysfunction in patients with acute cerebellar hemorrhage Shinichiro Maeshima 1, Aiko Osawa 1, Hiroshi Matsuda 2, Yasuhiro Miyazaki 1, Fumitaka Yamane 3, Shoichiro Ishihawa 3, Hiroki Kurita 4, Aikira Satoh 4, Norio Tanahashi 5 1 Department of Rehabilitation Medicine, 2 Department of Nuclear Medicine, 3 Department of Endovascular Neurosurgery, 4 Department of Cerebrovascular Neurosurgery, 5 Department of Neurology, Saitama Medical University International Medical Center Recently, several reports suggest that cerebellar damage is associated with visual cognitive disorder, executive dysfunction, and affective change. Focusing on cognitive impairment in cerebellar hemorrhage, we evaluated the relationship between cognitive function and hematoma volume, foci, and cerebral blood flow. An abnormality was detected in 83.3% with the Mini - mental state examination, in 64.5% with the Raven s colored progressive matrices and 76.5% with the Frontal assessment battery. The presence of cognitive impairment did not correlate with hematoma size, while subjects with cognitive impairment had a decrease in regional cerebral blood flow in the thalamus and frontal temporal lobe. Cognitive impairments associated with cerebellar hemorrhage were not rare. A detailed assessment of cognitive function is therefore necessary also in patients with infratentorial lesions. Address correspondence to Dr. Shinichiro Maeshima, Department of Rehabilitation Medicine, Saitama Medical University International Medical Center 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan