Clinical Analysis Of 11 Cases Of Cerebellar Infarction

Objective:The management of cerebellar infarctions is controversial, We performed this study to explore the clinical characteristics and neuroimaging findings of cerebellar infarction, to find out the risk factors of cerebellar infarction, and which prediction of neurologic deterioration or the effect of intervention on out come, and which patients require surgical treatment and which surgical procedure should be performed when a patient with a cerebellar infarction exhibits progressive neurological deterioration.Methods:We studied 11 consecutive patients(6 male and 5 female patients; average age, 56 yr) with cerebellar infarction diagnosed by CT and/or MRI who were admitted to our hospitals during 2 years.Results:Cerebellar infarcts constituted 0.9% of the total patients with brain infarction. The backgrounds and risk factors were similar to those in patients with infarctions of the cerebral hemispheres, such as hypertension, Atrialfibrillation Hypercholesterolemia and Diabetes, and the diagnosis of embolism could not be ruled out in 2/11(18.2%). Of the 10 CT were abnormal, 1 was normal, 6 had MRI scans and all were abnormal. Infarcts involving the superior cerebellar artery (SCA) region (6%) and the posterior inferior cerebellar artery (PICA) region (5%) were far more frequent than those involving the anterior inferior cerebellar artery (AICA) region (1%). PICA region infarcts exhibited a triad of vertigo, headache, and gait imbalance predominated at stroke onset; Patients with SCA infarcts exhibited obtunded consciousness and ataxia more frequently than those with PICA infarcts (P<0.05).Of the 9 conservatively treated patients, 8 experienced good outcomes, and 1 died as a result of respiration failure; Of the 2 surgically treated patients, 1 experienced good functional recoveries (treated with external ventricular drainage only) and1 died (the one treated with suboccipital craniectomy plus external ventricular drainage). The overall mortality rate was 18.2% (2 of 11 patients).Discussion:acute cerebellar infarction may initially manifest in a clinically indolent manner, may manifest with vertigo, nausea, vomiting and ataxia, which requires constant vigilance by physicians. Certain easily identifiable clinical and imaging findings may assist in appropriate patient triage, and timely neurosurgical intervention is meaningful. Cerebellar stroke For patients with worsening levels of consciousness and radiologically evident ventricular enlargement, we recommend external ventricular drainage. We reserve surgical resection of necrotic tissue for patients whose clinical status worsens despite ventriculostomy, those for whom worsening is accompaniedby signs of brainstem compression, and those with tight posterior fossae. Various features previously correlated with a poor outcome include older age, gaze paresis, and diminished level of consciousness. Radiologic findings previously correlated to poor outcome include midline location, obliterated fourth ventricle and basal cisterns, upward herniation and hydrocephalus.