This chapter presents a brief background on the rationale for how the cerebellum is engaged in non-motor functions. It discusses the relationship of the cerebellar motor syndrome to the higher order aspects of cerebellar dysfunction. The chapter analyzes the nature of the neuro-behavioral deficits and their relationship to cerebellar structure and vascular anatomy. It examines the clinical relevance of the cognitive and behavioral manifestations of cerebellar stroke in the diagnosis and management of patients with posterior circulation ischemia. In stroke neurology, the natural and appropriate tendency is to consider stroke syndromes as manifestations of occlusions of specific blood vessels. Bedside and office-based tests that the neurologist can administer to detect the cerebellar cognitive affective syndrome (CCAS) should focus on the domains known to be affected, namely, disorders of executive function, visuospatial cognition, language-based tests, and assessment of affect and other neuropsychiatric domains.

Neuropsychological evidence offers a great deal to the understanding of normal cognition. This chapter focuses on the techniques and systematic investigations of both individual case studies and of groups of individuals who exhibit disorders of visuospatial working memory following damage to the brain. It addresses the possibility that working memory is best viewed as a multiple component system, and that within such a system, there might be further fractionation between visual and spatial resources with performance on some spatial tasks requiring the use of executive functions. This chapter talks about the relationship between visuospatial working memory, and other parts of the cognitive system by exploring whether or not visuospatial working memory acts as a gateway between perception and long-term memory. It then considers the impairments of different aspects of visuospatial working memory that arise from the phenomena of unilateral spatial neglect and of cortical blindness.