Posterior fossa syndrome after a vermian stroke: a new case and review of the literature

The posterior fossa syndrome (PFS) is a well-known clinical consequence of posterior fossa surgery that has only been reported in a limited number of cases with a non-tumoral etiology. It consists of transient cerebellar mutism, behavioral abnormalities and personality changes. We describe a 12-year-old child who developed transient cerebellar mutism associated with behavioral and emotional symptoms following rupture of a vermis arteriovenous malformation (AVM). Following the stroke, the girl experienced a 24-hour symptom-free interval. After that, she became mute and her emotional state was characterized by severe anxiety, irritability, and withdrawal. After three days, mutism resolved and dysarthria became apparent. Two weeks post-stroke, the AVM was surgically removed and the post-operative course was uneventful. This case is the first reported in which the PFS occurred after focal non-surgically induced cerebellar damage.