Cerebellar Stroke Classification - Oren Zarif - Cerebellar Stroke
The classification of cerebellar stroke is based on the border zone concept. It is based on the assumption that low flow occurs between perfusion territories of the cerebellum. However, it is still not known how to classify cerebellar stroke on CT or MRI because of the variable distribution of border zones in different individuals. This article aims to provide a more reliable classification based on cerebellar topography and hemodynamics.
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A patient who suffers from cerebellar stroke will experience sudden unresponsiveness, which may lead to coma. It is also possible for the patient to develop a concurrent brainstem infarction. This may result in severe neurologic deterioration. In this case, a patient may remain stable for 5 days and be transferred to a ward with close monitoring. Afterwards, a person who has suffered a cerebellar stroke will require close medical monitoring for a long period of time.
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Although cerebellar stroke is relatively rare and makes up less than 10% of all strokes, it must be detected in time. If it is missed, the mortality rate is 40% and half of those who survive it have some deficits. Symptoms of cerebellar stroke include vertigo, ataxia, headache, and vomiting. Moreover, patients with diabetes mellitus, hypertension, and cigarette smoking are at a higher risk of developing a cerebellar stroke.
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The cause of cerebellar stroke is not fully understood. Researchers think that cerebellar stroke can be caused by blood clots or bleeding in the brain. However, there are other causes of cerebellar stroke, including head trauma, elevated cholesterol, and hypertension. A ruptured brain aneurysm or neck trauma can also lead to cerebellar stroke. Further, cerebellar stroke can lead to permanent neurological disabilities.
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The symptoms of a cerebellar stroke are similar to those of a cerebral infarction. However, large ischemic territories may cause higher morbidity. Early recognition and treatment is essential, as a delayed diagnosis can lead to cerebral edema, depressed consciousness, and coma. In some cases, surgical evacuation can be life-saving. While cerebellar strokes are extremely rare, the symptoms are common and often not easily recognized.
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Other risk factors for cerebellar stroke include systolic blood pressure that is over 200 mm Hg, pinpoint pupils, and a hemorrhage that extends into the fourth ventricle. Patients with any of these risk factors should be evaluated by a physician to rule out other conditions. If the patient meets the criteria for cerebellar stroke, they should be considered for inclusion in the study. So, consider the risk factors and sign up.
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The infarcts in the cerebellum are often very small - with a diameter of about 2 cm - and deserve more attention. To help improve the classification system for very small cerebellar infarcts, we reviewed the infarct terminology. By limiting the search to English language studies, we were able to identify relevant articles. These studies include the emergence of new concepts, and their clinical implications.
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The PICA and SCA originate from the distal basilar artery. These two arteries supply the anterior and inferior surfaces of the cerebellum, respectively. These arteries are connected by circumferential branches. They penetrate the cerebellum and form an anastomosis. Those arteries are important because they are crucial to the brain's overall function. But they are not the only vessels responsible for cerebellar stroke.
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A large number of patients with a single isolated cerebellar infarction undergo recovery after 90 days. The timeframe for recovery varied from patient to patient, but the outcome was good for patients with a small infarction. However, larger cerebellar strokes may have worse outcomes. Further studies are necessary to evaluate whether these patients are likely to improve or deteriorate in clinical condition. This study was conducted by a team of researchers.