Cerebellar stroke

Abstract

Cerebellar infarction and hemorrhage share symptoms and signs according to the cerebellar structures affected. Although the clinical features of isolated cerebellar infarction are similar across the three main cerebellar vascular territories, dysarthria is most likely to be associated with lesions in the territory of the superior cerebellar artery, whereas vertigo and lateropulsion appear to be more often seen in lesions involving the territory of the posterior inferior cerebellar artery. Audio-vestibular symptoms are characteristic in lesions in the anterior inferior cerebellar artery territory. The main etiologies of cerebellar stroke are artery-to-artery embolism and cardioembolism, followed by in situ branch atherosclerosis. The increasing availability of MRI and advent of new imaging techniques prompt us to better define the cerebellar stroke syndromes and identify the mechanism of stroke. Acute cerebellar stroke requires constant vigilance by clinicians owing to often rapid clinical deterioration. This deterioration results from brainstem compression by mass effect, evolving hydrocephalus, or irreversible brainstem infarction. Medical therapy, vascular procedures, or surgical interventions can improve patients’ outcomes. The chapter reviews cerebellar stroke, from clinical features to the mechanism, potential complications, diagnosis, and treatment of patients.