Development of a psychiatric disorder linked to cerebellar lesions

Objectives Cerebellar dysfunction plays a critical role in neurodevelopmental disorders with long-term behavior and neuropsychiatric symptoms. Case A 43-year-old woman with a cerebellum arteriovenous malformation and history of behavioral dysregulation since childhood is described. After the ruptured of the cerebellar malformation in adulthood, her behavior morphed into specific psychiatric symptoms and cognitive deficits occurred. Results The neuropsychological assessment evidenced impaired performances in attention, visuospatial, memory, and language domains. Moreover, psychiatric assessment indicated a borderline personality disorder. Brain MRI examination detected macroscopic abnormalities in the cerebellar posterior lobules VI, VIIa (Crus I), and IX, and in the posterior area of the vermis, regions usually involved in cognitive and emotional processing. Conclusions The described patient suffered from cognitive and behavioral symptoms that are part of the Cerebellar Cognitive Affective Syndrome. This case supports the hypothesis of a cerebellar role in personality disorders emphasizing the importance of also examining the cerebellum in presence of behavioral disturbances in children and adults.