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Atherothrombotic cerebellar infarction: vascular lesion-MRI correlation of 31 cases
1Department of Neurology, Kyungpook National University Hospital, Taegu, South Korea.
Background And Purpose:
Correlation of MRI findings with atherosclerotic vascular lesions has rarely been attempted in patients with cerebellar infarction. The aim of this study was to correlate the MRI lesions with the vascular lesions seen on conventional cerebral angiography in cerebellar infarction.
Methods:
The subjects included 31 patients with cerebellar infarcts who underwent both MRI and conventional cerebral angiography. We analyzed the risk factors, clinical findings, imaging study, and angiography results. We attempted to correlate MRI lesions with the vascular lesions shown in the angiograms.
Results:
The vascular lesions seen on angiograms were subdivided into 3 groups: large-artery disease (n=22), in situ branch artery disease (n=6), and no angiographic disease with hypertension (n=3). The proximal segment (V1) lesions of vertebral artery were the most common angiographic features in patients with large-artery disease in which stroke most commonly involved the posterior inferior cerebellar artery (PICA) cerebellum. The V1 lesions with coexistent occlusive lesions of the intracranial vertebral and basilar arteries were correlated with cerebellar infarcts, which had no predilection for certain cerebellar territory. The intracranial occlusive disease without V1 lesion was usually correlated with small cerebellar lesions in PICA and superior cerebellar artery (SCA) cerebellum. The subclavian artery or brachiocephalic trunk lesion was associated with small cerebellar infarcts. The in situ branch artery disease was correlated with the PICA cerebellum lesions, which were territorial or nonterritorial infarct. No angiographic disease with hypertension was associated with small-sized cerebellar infarcts within the SCA, anterior inferior cerebellar artery, or SCA cerebellum.
Conclusions:
Our study indicates that the topographic heterogeneity of cerebellar infarcts are correlated with diverse angiographic findings. The result that large-artery disease, in which nonterritorial infarcts are more common than territorial infarcts, is more prevalent than in situ branch artery disease or small-artery disease, suggest that even a small cerebellar infarct can be a clue to the presence of large-artery disease.
Insights
Cerebellar infarcts show diverse MRI findings correlating with various atherosclerotic vascular lesions. Even small infarcts may indicate underlying large-artery disease, prompting further investigation.
Area of Science:
- Neurology
- Radiology
- Vascular Medicine
Background:
- Cerebellar infarction diagnosis often relies on imaging, but correlation with underlying atherosclerotic vascular lesions is underexplored.
- Magnetic Resonance Imaging (MRI) and conventional cerebral angiography are key diagnostic tools.
Purpose of the Study:
- To correlate MRI-detected cerebellar infarcts with vascular lesions identified via conventional cerebral angiography.
- To investigate the relationship between infarct topography and specific atherosclerotic disease patterns.
Main Methods:
- Retrospective analysis of 31 patients with cerebellar infarcts who underwent both MRI and cerebral angiography.
- Evaluation of patient risk factors, clinical presentation, MRI findings, and angiographic results.
- Categorization of vascular lesions into large-artery disease, in situ branch artery disease, and no angiographic disease with hypertension.
Main Results:
- Large-artery disease was the most common finding (n=22), often associated with posterior inferior cerebellar artery (PICA) cerebellum infarcts.
- Proximal vertebral artery (V1) lesions were frequent in large-artery disease, with infarcts showing no specific territorial predilection.
- Intracranial occlusive disease without V1 lesions correlated with smaller infarcts in PICA and superior cerebellar artery (SCA) territories. In situ branch artery disease primarily affected PICA cerebellum.
Conclusions:
- Cerebellar infarcts exhibit topographic heterogeneity linked to diverse angiographic findings.
- Large-artery disease, characterized by more nonterritorial infarcts, is prevalent and can be suggested by even small cerebellar infarcts.
- Understanding these correlations aids in diagnosing the underlying cause of cerebellar infarction.
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