Cerebellar Stroke - Oren Zarif - Cerebellar Stroke

Cerebellar infarctions are categorized based on their location and size. Small cerebellar infarctions are typically found in border zones between cerebral perfusion territories. The traditional classification system relies on presumed vascular boundaries. The cerebellum is divided into two halves: the anterior and posterior lobes. The distribution of small infarcts varies widely among patients. Infarct sizes are usually small.

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Acute mass effect in the posterior fossa can occur. The posterior fossa contains a much smaller volume than the supratentorial compartment. This type of hemorrhage can cause progressive decline in alertness and obliteration of the fourth ventricle and basal cisterns. Surgical evacuation prevented this potentially fatal event. However, a large percentage of patients with cerebellar stroke do not have the right brainstem volume or position to undergo surgery.

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Although cerebellar stroke is rare and accounts for only 10% of all strokes, if missed, mortality is up to 40%. In addition, half of the survivors have significant long-term disabilities. Cerebellar stroke symptoms include vertigo, headache, nausea, and vomiting. There are other risk factors associated with cerebellar stroke including diabetes mellitus, hypertension, cigarette smoking, and stroke-related disability. If the symptoms are present, prompt neurosurgical intervention is required.

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Because symptoms of cerebellar stroke are non-specific, doctors may confuse it with other health conditions. The most common cause is a blood clot. This clot may form in other parts of the body and travel to the cerebellum. Cerebellar hemorrhage can also occur after a traumatic injury to the head. As a result, a blood clot may lodge in the brain and block the regular blood flow.

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Cerebellar stroke survivors often experience difficulty walking and losing control of their fine motor movements. These symptoms are often called cerebellar ataxia. The condition is characterized by impaired muscle control in the arms, legs, and trunk. Survivors may find it difficult to complete complex, time-sensitive movements. Even more problematic, complex movements involving several muscles may become jerky. Leg ataxia may cause unsteady strides.

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After an initial diagnosis of cerebellar stroke, a patient should be admitted to the neurologic intensive care unit for 72-96 hours. A physician will frequently reassess the patient and observe the patient for signs of deterioration. Patients with stable neurological conditions are unlikely to deteriorate. A patient should undergo neurologic imaging to identify any signs of brain injury. While MRIs are the most reliable imaging tests for cerebellar stroke, CT scans may not be completely helpful.

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Cerebellar stroke symptoms vary depending on the severity of the lesion and the location of the brainstem. A thorough history and neurological exam are necessary to determine the exact type of stroke. Cerebellar stroke symptoms are often nonspecific and may be misinterpreted as other illnesses. Early detection is the key to ensuring the proper course of treatment. But if symptoms persist or get worse, you should immediately seek medical attention. It is vital to recognize the early signs of cerebellar stroke and to prevent complications from developing.

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The severity of cerebellar deficits is associated with the MICARS score at baseline, lesion location, and days after symptom onset. In patients with SCA territory, higher baseline MICARS scores were associated with more severe symptoms. The clinical relevance of cognitive and behavioral manifestations of cerebellar stroke is explored. The role of transcranial magnetic stimulation in the management of cerebellar stroke is also discussed. The chapter concludes with recommendations for further research on the clinical outcomes of cerebellar stroke.

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The symptoms of cerebellar stroke are symptomatic and can include a 66-year-old man who had the worst headache of his life. Within a matter of hours, he became completely unresponsive. A heart-rate-reducing ventricular tachycardia was detected, and he was resuscitated. An HCT revealed a hematoma of four centimeters in the left cerebellar hemisphere and obliterated basal cisterns. The man was transferred to the University of Iowa Hospitals and Clinics. He was transferred to a comatose state with a blood pressure of 67/50 mm Hg.

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Imaging techniques for cerebellar infarction are more limited than those for other brain areas. Magnetic resonance imaging with diffusion-weighted imaging is the gold standard. It allows doctors to visualize vascular occlusions and detect signs of tissue injury. Magnetic resonance angiography (MRI) can also guide endovascular treatment in cases of large vascular occlusions. Unenhanced computed tomography, or CT, can occasionally demonstrate cerebellar infarction, but it is largely limited by the radiopaque temporal and occipital bones.

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Cerebellar hemorrhage and infarction are the two ends of the cerebellar vascular spectrum. Although they share some clinical characteristics, the two types of stroke are distinct in their risk factors and management. Cerebellar hemorrhage and infarction are often treated in the same hospital. Acute treatment includes surgical intervention. The diagnosis is often based on a patient's severity. If they are associated with symptoms and a diagnosis, they should be considered together.