The Clinical And Imaging Features Of Symmetrical Infarction Of Middle Cerebellar Peduncles

Objective and methodsClinicopathological reports on symmetrical infarction of middle cerebellar peduncle(MCP)are rare.In the present there only several cases with bilateral infarction of the MCP have been published.In this study we collect 20 cases of symmetrical infarction of MCP(4 cases were admitted to Qianfoshan Hospital Affiliated to Shandong University and 16 cases that have been published with bilateral infarction of the MCP).In this study we retrospective review the etiology,pathophysiological,anatomy,pathological mechanisms,clinical features,imaging features,diagnosis,differential diagnosis,and treatment of 20 patients with symmetrical infarction of MCP.In order to improve the diagnosis and treatment of this disease.ResultsAll of the 20 cases were bilateral infarction of the MCP.Most of patients(12,60%)had isolated bilateral infarction of MCP.Of which 16 male(16,80%),female(4,20%);the age(51~87)years,average(62.1 ± 9.93)years.All of the 20 patients with the risk factors for cerebrovascular disease: hypertension(19,95%);smoker(7,35%);diabetes(4,20%);hypercholesterolemia(5,25%);alcoholism(2,10%),a case with cerebral infarction,atrial fibrillation,coronary artery disease,myocardial infarction,hyperuricemia or depression.pathogeny: atherosclerosis(18,90%);hypoplastic vertebral artery(VA)with other VA disse ction 1 case,trauma-induced arterial dissection in 1 case.Clinical manifestations: Vert igo(17,85%);dysarthria(17,85%);ataxia(17,85%);deafness/tinnitus(13,65%);nystagmus(9,45%);motor weakness(6,30%);nausea/vomiting(6,30%);facial sensory impairment(3,15%);Babinski sign(3,15%);paropsia,facial palsy,headache,diplopia,pharyngeal reflex decrease in 2 cases;dysphagia,abducens palsy,limbs reflection decrease and hypesthesia in 1 cases.Distribution of cerebral infarction: all of the patients involved bilat eral MCP;the cerebellum in 8 cases;pons in 2 cases.Cerebrovascular examination: all of the patients with vertebrobasilar artery stenosis or occlusion.Bilateral VA lesions in 12 patients(one side VA occlusion and contralateral vertebral artery stenosis in 8 cases;bilateral VA occlusion in 4 patients),vertebrobasilar Artery stenosis in 2cases;Basilar Artery(BA)stenosis in 2cases.Bilateral anterior inferior cerebellar artery(AICA)were well visualized in 6 cases.After admission to inhibit platelet aggregation,anti-atherosclerotic,scavenging oxygen free radicals,improve cerebral circulation,trophic nerve and support treatment.The significant gradually resolved after treament.The patient 1 and 2 admitted by Qianfoshan Hospital also received stent implantation and the effect was significant.ConclusionThe middle cerebellar peduncle(MCP)is the core of the territory largely supplied by the AICA.Vertigo and ataxia are the common symptoms of MCP infarction and cranial nerve damage often involved.Symmetrical MCP infarction are contribute to alternations of two vessels,such as the unilateral vertebral artery and basilar artery or both vertebral arteries.Hypoperfusion may also play a critical role in symmetrical MCP infarction.In addition to cerebral infarction,other various diseases may cause bilateral MCP lesion.The treatment of bilateral infarction of the MCP is similar to ischemic stroke,besides the conventional medical treatment,intravascular interventional therapy also be choice by patients and doctors.