A study on lesion pattern of bilateral cerebellar infarct

To explore the lesion patterns and stroke mechanism of the acute bilateral cerebellar infarct.

Patients admitted to Xiangyang Hospital with acute cerebellar infarcts, confirmed by diffusion-weighted imaging (DWI), were investigated. Patients were divided into two groups by lesions: unilateral cerebellar infarct (UCI) and bilateral cerebellar infarct (BCI). The demographic features, involved territories and concomitant lesions outside the cerebellum (CLOC). The causes were analyzed.

Amongst the 115 patients hospitalized with posterior circulation cerebral infarct due to acute stroke, 56 patients had cerebellar infarct. There were 36 (64.3%) cases of unilateral cerebellar infarct and 20 (35.7%) cases of the BCI. The baseline information shows that stroke history (p = 0.002), fibrinogen (p = 0.036) and admission NIHSS score (M) (p = 0.001) for the BCI group are higher than the unilateral cerebellar infarct group. The incidence rate of cerebellar infarct in a posterior inferior cerebellar artery (PICA) blood supplying territory is the highest by divisions of vascular distribution. Unilateral cerebellar infarct occurs more often (p = 0.006); BCI is more common in PICA+SCA blood supplying territory (p = 0.004). The incidence rate of BCI merged with CLOC is much higher than the unilateral cerebellar infarct (p = 0.002). Merged infratentorial lesions are more common (p = 0.022) than BCI with atherosclerosis (p = 0.041). Offending artery diseases are mainly in the V4 segment of the vertebral artery, and in the severe stenosis or occlusion of V4 and BA junction.

BCI was frequently involved in the PICA + SCA territory. Our results support the fact that embolism resulted from large artery atherosclerosis is the important stroke mechanism in the BCI.