Cerebellar Stroke - Oren Zarif - Cerebellar Stroke
A cerebellar stroke can be caused by a number of different factors. A large infarct can affect the entire cerebellum, and a smaller infarct may involve just a portion of the cortex. This can result in a pronounced loss of brain function. A smaller infarct, on the other hand, is much more likely to affect just a small area of the cortex. In such cases, symptoms include a loss of grey-white differentiation and even facial paralysis.
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The first step in diagnosing a cerebellar stroke is to determine whether it is isolated or focal. Cerebellar stroke symptoms can be non-specific and depend on the exact location of the lesion. A thorough history and neurological exam are the key to determining the cause. However, there is an opportunity to rule out a cerebellar stroke through imaging tests. In the case of cerebellar stroke, imaging tests can identify bleeding or other issues in the brain. An MRI may be recommended before other tests, because it shows the cerebellum much more clearly than a CT scan can.
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Because cerebellar stroke has such variable clinical presentation, it is difficult to determine if it is a hemorrhagic or non-hemorrhagic stroke. To prevent a costly and ineffective surgical intervention, an interprofessional team of healthcare providers must evaluate the patient's symptoms and medical history. In cases of suspected cerebellar stroke, a high index of suspicion is crucial. If the patient is in a stable condition, he or she may be a candidate for neurosurgical intervention.
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The patient should be admitted to the neurologic intensive care unit for 72 to 96 hours. Surgical management of cerebellar stroke is highly individualized and should include a combination of resection and suboccipital craniectomy. A ventriculostomy may be sufficient for the temporizing phase of the condition. If a progressive brainstem compression is present, a craniectomy will be necessary to achieve definitive treatment.
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The patient's deterioration often follows the onset of cerebral edema, which may cause irreversible brain damage. A large cerebellar infarction can result in a coma within hours. A large cerebellar stroke can be fatal if there is extensive concurrent brainstem infarction. Although cerebellar stroke is rare, it can lead to coma. Amarenco9 reported that massive paramedian pontine infarction is the most common cause of coma.
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Other symptoms of a cerebellar stroke include jerky movements, facial drooping, and weakness in one arm. Cerebellar stroke can be difficult to identify because symptoms can mimic other ailments. It is therefore important to seek medical attention as soon as you notice any of these signs. The symptoms can be subtle or severe, depending on where the infarct is located in the cerebellum. But regardless of the onset, a cerebellar stroke is no laughing matter.
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Historically, it was believed that small cerebellar infarctions were caused by internal cerebellar artery watershed infarctions. However, these studies found that the distribution of small cerebellar infarcts varied among patients. The term "very small territorial infarcts" was later proposed. Then again, neither term is universal. In fact, vascular territories do not respect anatomical boundaries. A small cerebellar infarct typically appears oblique and is oriented orthogonally to the cerebellar fissures. A deep infarct, however, is typically without this characteristic.
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The symptoms of cerebellar infarction and hemorrhage are similar and should be treated as a neurologic emergency. However, early recognition and treatment can help reduce the morbidity of a cerebellar hemorrhage. However, if the hemorrhage is large enough, it could compress the brainstem and cause a cerebral edema. In the worst case, the patient may go into a coma or lose consciousness. If this occurs, surgical evacuation of the brainstem may save the life of the patient.
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Occupational therapy can help people with cerebellar stroke return to their normal daily activities. The therapist will help patients learn how to prepare meals and wash their clothes. As part of the rehabilitation process, patients may be prescribed assistive devices or walking aids to help them move around more easily. While it is impossible to fully rehabilitate the affected areas of the brain, the therapist can guide them through the correct cerebellar stroke treatment.
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Although cerebellar infarctions can take years to recover, patients with these small infarcts often do well within 90 days. Recovery may take a few months, and the long-term effects of the stroke may be permanent. Patients should discuss any treatment options with their physician to determine the best course of action. In the meantime, healthline natural is a great source to find new information on a variety of health topics.