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Generalized Cerebellar Ataxia of Acute Onset: Case Report
Arthur Antônio Freire Alves1, Arthur Felipe Barbosa Vasconcelos2, Francisco Anderson de Sá Carvalho2
1Departamento de Medicina Interna, Serviço de Neurologia, Universidade Federal da Paraíba, Campus I, Jardim Universitário, S/N, Castelo Branco, João Pessoa, PB, 58051-900, Brazil.
This case report details a 65-year-old male experiencing sudden neurological deficits due to a basilar artery top thrombus. The findings emphasize recognizing bilateral superior cerebellar artery territory infarcts in patients with cerebellar ataxia.
Area of Science:
- Neurology
- Vascular Neurology
- Neuroimaging
Background:
- A 65-year-old male with hypertension and atrial fibrillation presented with acute neurological symptoms.
- Irregular medication adherence for hypertension was noted.
- The patient reported sudden onset of dizziness, dysarthria, and bilateral ataxia.
Observation:
- Cranial MRI revealed infarcts in the bilateral superior cerebellar arteries and left pons.
- CT angiography demonstrated thromboembolic occlusion at the top of the basilar artery.
- Electrocardiogram confirmed atrial fibrillation.
Findings:
- The patient was diagnosed with an ischemic stroke affecting the bilateral superior cerebellar artery territories secondary to a basilar artery top thrombus.
- Treatment included metoprolol and dabigatran.
- Partial symptom improvement was observed upon discharge.
Implications:
- This case underscores the significance of considering bilateral superior cerebellar artery infarcts in patients with global cerebellar ataxia, even without altered consciousness or vision.
- Prompt diagnosis and management of basilar artery top thrombosis are crucial for preventing severe neurological deficits.
- Highlights the importance of anticoagulation in patients with atrial fibrillation and embolic stroke.
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