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Research Article| Volume 14, ISSUE 5, P193-198, September 2005

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Multiple Cerebellar Infarcts: Clinical and Pathophysiologic Features

      We investigated the clinical features of 15 patients with multiple isolated ischemic lesions in the cerebellum. The main initial symptoms were vertigo and nausea/vomiting in 8 patients each, and headache in 6 patients. Dysarthria and cerebellar ataxia of the limbs and trunk were observed in 14 patients. The ischemic lesions were in the posterior inferior cerebellar artery (PICA) plus superior cerebellar artery (SCA) territories in 4 patients (27%), and PICA plus SCA plus anterior inferior cerebellar artery (AICA) territories in 3 patients (20%). Infarcts were in the AICA plus SCA territories in 2 patients (13%), PICA only in 2 patients (13%), and SCA only in 4 patients (27%). Hemorrhagic lesions were observed in the ischemic area in 2 patients (13%). Vascular lesions included occlusive lesions of the vertebral arteries in 9 patients (60%), but no abnormalities of the vertebrobasilar arterial system were observed in 6 patients (40%). The functional prognosis was good in most cases. The underlying mechanism was atherothrombotic, including arteriogenic embolism in 9 patients (60%) and cardiogenic embolism in 3 patients (20%). An embolic mechanism was considered in all cases, but in some cases an accurate pathogenesis of the cerebellar infarction was obscure.

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      References

        • Tatu L.
        • Moulin T.
        • Bogousslavsky J.
        • et al.
        Arterial territories of human brain.
        Neurology. 1996; 47: 1125-1135
        • Caplan L.R.
        Cerebellar infarcts.
        in: Caplan L.R. Posterior circulation vascular disease clinical findings, diagnosis and management. Blackwell Science, 1996: 492-543
        • Caplan L.
        Posterior circulation ischemia: then, now, and tomorrow. The Thomas Willis Lecture 2000.
        Stroke. 2000; 31: 2011-2023
        • Amarenco P.
        Cerebellar stroke syndrome.
        in: Bogousslavsky J. Caplan L. Stroke syndromes. Cambridge University Press, Cambridge, UK2001: 540-556
        • Amarenco P.
        • Roullet E.
        • Hommel M.
        • et al.
        Infarction in the territory of the medial branch of the posterior inferior cerebellar artery.
        J Neurol Neurosurg Psychiatry. 1990; 53: 731-735
        • Amarenco P.
        The spectrum of cerebellar infarctions.
        Neurology. 1991; 41: 973-979
        • Barth A.
        • Bogousslavsky J.
        • Regli F.
        The clinical and topographic spectrum of cerebellar infarcts.
        Ann Neurol. 1993; 33: 451-456
        • Chaves C.J.
        • Caplan L.R.
        • Chung C.-S.
        • et al.
        Cerebellar infarcts in the New England Medical Center posterior circulation stroke registry.
        Neurology. 1994; 44: 1385-1390
        • Barth A.
        • Bogousslavsky J.
        • Regli F.
        Infarcts in the territory of the lateral branch of the posterior inferior cerebellar artery.
        J Neurol Neurosurg Psychiatry. 1994; 57: 1073-1076
        • Canaple S.
        • Bogousslavsky J.
        Multiple large and small cerebellar infarcts.
        J Neurol Neurosurg Psychiatry. 1999; 66: 739-745
        • Terao S.
        • Miura N.
        • Osano Y.
        • et al.
        Cerebellar infarction in the territory of the medial branch of the posterior inferior cerebellar artery.
        J Aichi Med Univ Assoc. 2000; 28: 85-90
        • Tohgi H.
        • Takahashi S.
        • Chiba K.
        • et al.
        Cerebellar infarction.
        Stroke. 1993; 24: 1697-1701
        • Terao S.
        • Sobue G.
        • Izumi M.
        • et al.
        Infarction of superior cerebellar artery presenting as cerebellar symptoms.
        Stroke. 1996; 27: 1679-1681
        • Tada Y.
        • Mizutani T.
        • Nishimura T.
        • et al.
        Acute bilateral cerebellar infarction in the territory of the medial branch of the posterior inferior cerebellar arteries.
        Stroke. 1994; 25: 686-688
        • Kang D.W.
        • Lee S.H.
        • Bae H.J.
        • et al.
        Acute bilateral cerebellar infarction in the territory of the posterior inferior cerebellar artery.
        Neurology. 2000; 55: 582-584
        • Gurer G.
        • Sahin G.
        • Cekirge S.
        • et al.
        Acute bilateral cerebellar infarction in the territory of the medial branches of posterior inferior cerebellar arteries.
        Clin Neurol Neurosurg. 2001; 103: 194-196
        • Caplan L.R.
        “Top of the basilar” syndrome.
        Neurology. 1980; 30: 72-79
        • Mehler M.F.
        The rostral basilar artery syndrome.
        Neurology. 1989; 39: 9-16
        • Norrving B.
        • Magnusson M.
        • Holtas S.
        Isolated acute vertigo in the elderly.
        Acta Neurol Scand. 1995; 91: 43-48
        • Amarenco P.
        • Hauw J.-J.
        Cerebellar infarction in the territory of the superior cerebellar artery.
        Neurology. 1990; 40: 1383-1390
        • Graf K.J.
        • Pessin M.S.
        • DeWitt L.D.
        • et al.
        Proximal intracranial territory posterior circulation infarcts in the New England Medical Center Posterior Circulation Registry.
        Eur Neurol. 1997; 37: 157-168
        • Min W.K.
        • Kim Y.S.
        • Kim J.Y.
        • et al.
        Atherothrombotic cerebellar infarction. Vascular lesion: MRI correlation of 31 cases.
        Stroke. 1999; 30: 2376-2381
        • Shim S.C.
        • Yoo D.H.
        • Lee J.K.
        • et al.
        Multiple cerebellar infarction due to vertebral artery obstruction and bulbar symptoms associated with vertical subluxation and atlanto-occipital subluxation in ankylosing spondylitis.
        J Rheumatol. 1998; 25: 2464-2468