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[A study of MRI and clinical neurology in acute cerebellar infarcts]
M Fujimoto1, T Ohashi, H Shimizu
1Department of Neurology, Seirei Hamamatsu General Hospital.
Abstract:
We studied clinical manifestations of sixteen patients with cerebellar infarcts diagnosed by MRI. In fourteen of them, the stroke developed abruptly with vertigo, which continued for several days. At the early stage of illness, ataxia was obscure. But after vertigo and nausea disappeared, nine cases showed truncal ataxia, while limb ataxia was found in only five. Their vertigo was rotatory and aggravated by head movement. Gaze-evoked nystagmus was observed in only 5 cases. Four patients preferred to take unilateral posture since they experienced less vertigo. The side of their lesions was the lower side of their posture. Limb ataxia was more frequent in SCA-involving cases than in SCA-non involving cases (3 out of 6 vs 2 out of 10, respectively). On the other hand, headache was more frequent in PICA-involving cases than in PICA-non-involving cases (6 out of 11 vs 1 out of 5, respectively). Ataxic gait was seen more in medial branch-involving cases than medial branch non-involving cases (5 out of 6 vs 4 out of 10, respectively). One patient died due to obstructive hydrocephalus.
Insights
Cerebellar infarcts often present with sudden vertigo. Truncal ataxia is more common than limb ataxia following the resolution of vertigo and nausea in these stroke patients.
Area of Science:
- Neurology
- Neuroimaging
- Clinical Medicine
Context:
- Cerebellar infarcts are a significant cause of neurological deficits.
- Magnetic Resonance Imaging (MRI) is crucial for diagnosing cerebellar strokes.
- Understanding the clinical spectrum of cerebellar infarcts is essential for timely management.
Purpose:
- To investigate the clinical manifestations of cerebellar infarcts diagnosed via MRI.
- To correlate specific symptoms and lesion locations with clinical outcomes.
Summary:
- Sixteen patients with cerebellar infarcts were studied using MRI.
- Sudden onset vertigo was the predominant initial symptom in 14 patients.
- Truncal ataxia was more prevalent than limb ataxia after vertigo subsided.
- Lesion location, including Superior Cerebellar Artery (SCA) and Posterior Inferior Cerebellar Artery (PICA) involvement, influenced ataxia and headache frequency.
- Ataxic gait was more common with medial branch involvement.
Impact:
- Highlights the typical presentation of cerebellar infarcts, emphasizing vertigo and subsequent truncal ataxia.
- Provides insights into the relationship between specific vascular territories (SCA, PICA) and clinical features.
- Underscores the importance of neuroimaging in identifying cerebellar strokes and guiding clinical assessment.