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Cerebellar infarct patterns: The SMART-Medea study.

Laurens J L De Cocker1, Mirjam I Geerlings2, Nolan S Hartkamp1

  • 1Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.

Neuroimage. Clinical
|June 25, 2015
PubMed
Summary

Small cerebellar infarcts are common incidental findings on MRI, often affecting the cortex and posterior lobes. These small infarcts, typically under 20 mm, show characteristic patterns and spare white matter.

Keywords:
CerebellumCerebrovascular diseaseMRI

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Area of Science:

  • Neurology
  • Radiology
  • Neuroimaging

Background:

  • Cerebellar infarct studies traditionally focus on acute, symptomatic cases.
  • Previous imaging predominantly used transversal MRI sequences.
  • Limited data exists on incidental cerebellar infarcts and their 3D imaging characteristics.

Purpose of the Study:

  • To investigate the prevalence and 3D imaging patterns of cerebellar infarcts found incidentally on MRI.
  • To characterize the topography, size, and tissue involvement of these infarcts.

Main Methods:

  • Analysis of 1.5 Tesla MRI 3D T1-weighted datasets from 636 patients in the SMART-Medea study.
  • Assessment of infarct characteristics: size, cavitation, gliosis, grey/white matter involvement, and topography.
  • Detailed evaluation of infarct location and relationship to cerebellar fissures.

Main Results:

  • 11% of patients (70/636) had one or more cerebellar infarcts (mean 1.97 per patient).
  • 138 infarcts were identified, predominantly small (95% < 20 mm) and cortical (97%).
  • Most infarcts (87%) were in the posterior lobe, often involving fissures but sparing subcortical white matter.

Conclusions:

  • Small cerebellar infarcts are more common than previously recognized, particularly as incidental findings.
  • These infarcts preferentially involve the cerebellar cortex, especially in the posterior lobes.
  • Characteristic topographic patterns of small cortical infarcts were observed, with white matter sparing.