Posttraumatic-Delayed Cerebellar Syndrome

We read with great interest the article by Louis et al¹ characterizing the clinical features of delayed-onset cerebellar syndrome. In 3 cases, cerebellar signs appeared up to 2 years after head trauma with initial comatose state. There are many reports of delayed tremor and other movement disorders following central and peripheral trauma, but head trauma is not usually regarded as a common cause for delayed cerebellar dysfunction. We recently encountered a patient in whom a progressive cerebellar syndrome developed 5 years after head trauma. This 55-year-old woman had been involved in a car crash 5 years earlier that resulted in a brain concussion. She was comatose for a few hours and remained without any apparent neurological deficit on discharge. Five years later, progressive instability of gait and dysarthria were noted. She was not taking any medication, and there was no family history of cerebellar disease. On examination she had