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Cerebellar Stroke - Oren Zarif - Cerebellar Stroke

Although cerebellar strokes represent only a small proportion of all cerebral strokes, their mortality rate is high. The true incidence may be higher, as most are small and go unrecognized. Patients often suffer from nonspecific symptoms, and therefore the clinical diagnosis relies on careful neurological examination. Signs include ataxia, headache, and vertigo. Other risk factors include hypertension and cigarette smoking. In addition, patients may present with altered consciousness.

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The clinical and imaging features of cerebellar stroke are important in guiding treatment. Surgical intervention should be considered when there are signs of cerebral hemorrhage. A large retrospective study of patients with cerebellar hemorrhage demonstrated that 46% of initially alert patients experienced neurologic deterioration. This was associated with a decreased level of consciousness, worsened motor response on the Glasgow Coma Scale (GCS), and the development of new brainstem signs.

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MR and CT studies have shown that small cerebellar infarcts are often misdiagnosed as a result of inadequate blood flow. Large cerebellar infarcts have a dramatic clinical course, and the small infarcts remain undetected. MRI and CT scans are useful tools for detecting cerebellar microinfarcts. In addition, the use of neuroimaging, such as high-field strength and diffusion-weighted imaging, has improved the diagnosis of cerebellar stroke.

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Patients with cerebellar stroke often present with nonspecific neurological symptoms, which are more common than obvious signs of vision or coordination problems. Because these symptoms may not be immediately apparent, patients often ignore these signs and may seek treatment when they become too severe. The treatment of cerebellar stroke depends on where the lesion occurs and how long it takes. During the recovery period, survivors should expect to undergo a series of treatments and have their condition monitored closely.

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The cerebellum is a part of the brain that controls balance, coordination of eye and body movements. It is located at the lower back of the brain and is supplied by several blood vessels. Cerebellar stroke affects one side of the cerebellum, affecting the left or right hemisphere. Because the cerebellum is small, a stroke may affect only one side. When this happens, the patient can lose all of their bodily functions, including balance.

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The first warning signs of a cerebellar stroke are sudden, unresponsive coma. Some people develop a coma within a few hours. However, in many cases, cerebellar infarctions may have a concurrent brainstem infarction. Symptoms associated with a cerebellar infarct include severe headache and a tendency to veer to the right while walking. A magnetic resonance imaging scan will show that the infarct occurred in the medial left cerebellum.

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A clinical examination for cerebellar stroke will reveal a variety of deficits. NIHSS scores of patients suffering from cerebellar stroke may be low, despite the fact that these strokes may be isolated. However, more specific scales may indicate a more severe deficit. It is also important to note that the lesion location and age at onset of the stroke did not affect the recovery of patients with cerebellar symptoms.

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Patients with cerebellar stroke are at higher risk for a cerebral infarction than patients with other types of strokes. Cerebellar stroke is very rare, accounting for less than 2% of all strokes. Survivors of cerebellar stroke must ask the right questions to help them cope with their unique situation. The key is to learn more about their unique symptoms and the specific rehabilitation treatments for cerebellar stroke. For patients with mild-to-moderate stroke, a ventriculostomy may be sufficient for temporary temporizing. Progressive brainstem compression may require a craniectomy.

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One patient with cerebellar stroke experienced the most serious headache he had ever had. Within hours, he became unresponsive and intubated. After ventricular tachycardia, he was transported to the emergency department. Noncontrast MR imaging revealed a four-cm hematoma in his right cerebellar hemisphere and effacement of the basal cisterns. He was transferred to the University of Iowa Hospitals and Clinics. The patient recovered from the coma.

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Infarcts in the cerebellar gyrus are often very small, with a diameter of only two centimeters. Therefore, further research is necessary to explore the potential deterioration of clinical outcomes in patients with cerebellar strokes. The authors acknowledge the contributions of the other researchers. They were responsible for conception and analysis of the study. All authors reviewed and approved the final version. These researchers hope that this review will help clarify the diagnosis of cerebellar stroke.

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