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Cerebellar stroke is a fairly rare type of stroke that is definitely worth talking about despite its low frequency. The reason why this unit should attract attention is in this case that cerebellar infarct - especially shortly after its onset - produces low intensity, very non-specific symptoms, so the necessary treatment may be delayed. So what ailments may be suggested by cerebellar stroke and what tests should be performed in order to diagnose this disease?

Cerebellar stroke(cerebellar stroke or cerebellar infarct) can occur at any age - even in a child - generally, however, it is a disease typical for adults (the risk of its occurrence increases with age and the greatest risk of developing a cerebellar stroke have elderly patients).

Like other elements of the central nervous system, the cerebellum can be affected by various pathological processes - the most common of these is cerebellitis, but it is also possible to develop a disease that is mentioned much less often and which is cerebellar infarct. Generally, this problem is not common - the literature mentions that it accounts for less than 10% of all strokes, but other authors provide much more precise data and mention that cerebellar infarct accounts for about 2% of all stroke cases.

Cerebellar and hemorrhagic stroke: causes

Like other strokes, the stroke of the cerebellum can be ischemic or hemorrhagic. The first of these may occur when blood vessels, which are responsible for the supply of blood to the cerebellum, become blocked - for example by a thrombus. We are talking about such structures as:

  • inferior anterior cerebellar artery
  • posterior inferior cerebellar artery
  • superior cerebellar artery

It happens, however, that the cerebellar infarction develops in a hemorrhagic mechanism - in this case, damage to the nerve tissue in the posterior cranial fossa may be a consequence of experiencing a head injury, but also spontaneous - e.g. due to significantly increased blood pressure - cracksblood vessels. There is also the possibility that a hemorrhagic stroke will develop as a result of damage to the vascular structures by the developing intracranial tumor.

It is worth mentioning here that there are also several risk factors for cerebellar stroke, which are:

  • elevated blood cholesterol levels
  • smoking
  • hypertension (especially if untreated or insufficiently controlled)
  • obesity
  • diabetes
  • insufficient physical activity
  • atherosclerosis

Cerebellar stroke: symptoms

A serious problem related to cerebellar infarct is that the ailments that appear in its course - especially at the beginning - are very nonspecific and may not give rise to the suspicion that the patient suffered from this disease at all. Shortly after the onset of this form of stroke, the patient may experience, among others :

  • dizziness
  • nausea
  • headaches
  • receiving a duplicate image
  • tremors

However, with time and progressive damage to the nervous tissue, patients may develop further, much more worrying ailments, such as :

  • motor coordination disorders
  • intensification of tendon reflexes
  • difficulty swallowing
  • speech disorder
  • uncontrolled eye movements

Ultimately - especially in the absence of treatment - patients with cerebellar infarct may develop disturbances of consciousness, sometimes even in the form of a coma. It is precisely the risk of its occurrence that indicates the importance of proper diagnosis when suspecting cerebellar stroke.

Cerebellar stroke: diagnosis

It should be emphasized here that it is not easy to put forward even the mere assumption of a cerebellar stroke - firstly, it is because this disease is relatively rare, in addition, ailments that appear in its course may suggest many other diseases, such as subarachnoid hemorrhage, meningitis or encephalitis.

Generally, a patient who reports to a doctor with the above-mentioned symptoms is initially pre-performed with a neurological examination - it enables the detection of certain abnormalities (such as difficulty in performing the finger-to-nose test correctly) that are related to a stroke However, this examination alone does not allow for the diagnosis of cerebellar infarction.

For this purpose, it is necessary to perform imaging tests, such as magnetic resonance imaging orcomputed tomography of the head. It is thanks to them that it is possible to detect ischemic foci within the cerebellum or intracranial bleeding responsible for the cerebellar stroke. Sometimes, in the diagnosis of the disease, other tests are performed, such as, for example, magnetic resonance angiography.

Cerebellar stroke: treatment

It is important not only to state that the patient has experienced a cerebellar stroke, but also to determine whether he or she has had a hemorrhagic or ischemic stroke - the treatment of a cerebellar stroke differs depending on the exact mechanism in which it occurred.

In the event of a haemorrhagic stroke, the most important thing is to stop active bleeding, and it may also be necessary to surgically evacuate the accumulated intracranial blood.

In patients with ischemic cerebellar infarction, the management depends on the time after which the patient is under the care of specialists - if this happens within the first 4.5 hours, it is usually possible to carry out thrombolytic treatment with the use of recombinant tissue plasminogen activator. Sometimes thrombectomy is also used in this case.

The above-described interactions are definitely not the only methods used in the treatment of cerebellar infarct. Initially - in order to stabilize the patients' condition - they may also be given drugs that lower blood pressure, anticonvulsants or preparations that reduce blood clotting. Patients must be carefully monitored - one risk that may develop within days of a cerebellar stroke is reactive brain swelling.

After the patient's condition is under control and his life is no longer threatening, he usually returns to his home. However, the treatment does not end there - in order to enable the patient to function in the best possible way after having suffered a cerebellar stroke, he is recommended to undergo regular rehabilitation.

Cerebellar stroke: prognosis

Overall, the prognosis for cerebellar infarct is considered worse than that of patients who experience a much more frequent stroke. As an example, there is data from one study in which it was estimated that just as stroke led to the death of just over 12% of patients, 23% of patients who contracted it died from stroke.

This situation arises from the fact that the symptoms of cerebellar stroke - as mentioned earlier - are non-specific, besides, patients often ignore them at first and therefore report todoctor late after the onset of the disease.

Delay in starting treatment in this situation significantly worsens the prognosis, therefore, when suddenly new, disturbing ailments suddenly appear, the patient should see a doctor as soon as possible.

About the authorBow. Tomasz NęckiA graduate of medicine at the Medical University of Poznań. An admirer of the Polish sea (most willingly strolling along its shores with headphones in his ears), cats and books. In working with patients, he focuses on always listening to them and spending as much time as they need.

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Category:

Neurology