Presentation
The clinical presentation may be ambiguous, and initial computed tomography scan can be normal. [ncbi.nlm.nih.gov]
At the other end of the spectrum, some patients with cerebellar stroke may present in a moribund comatose state. [mayoclinic.pure.elsevier.com]
However, no statistically significant differences in total DFIM ( P =0.1) or the inpatient rehabilitation FIM change (ΔFIM) ( P =0.16) was present between the subgroups. [stroke.ahajournals.org]
Course
- Severe Clinical Course
[…] infarction which often determines the clinical course. [frontiersin.org]
Gastrointestinal
- Projectile Vomiting
Although working in the fields the previous day, he had a feeling of giddiness and had projectile vomiting. He was feeling dazed and uneasy and lied down for next 60 min. Subsequently, he noticed that he could not walk. [ijpm.info]
Ears
- Tinnitus
Patients with symptoms commonly peripheral in etiology (nystagmus, tinnitus, gait instability, etc.) were included in the study. Patient demographics, stroke risk factors, and gait assessments were recorded. [ncbi.nlm.nih.gov]
Tinnitus or abnormal sounds in ear sometimes leading to deafness. Double vision. [tandurust.com]
I had a high level of tinnitus and could not stand or stop vomiting for four days. I was admitted to the cardiac ward and my heart rate slowed and my blood pressure dropped. [stroke-survivors.co.uk]
My stroke side effects were dizziness (vertigo), double vision (diplopia) nystagmus ,staggering gait (ataxia),weakness of the right side, tinnitus and occurrences of bronchial spasms. [healthboards.com]
Symptoms and Signs a Direction changing or vertical, not inhibited by visual fixation and without any associated tinnitus suggests central rather than peripheral cause. b When muscles are contracted against resistance and the resistance is then suddenly [slideshare.net]
Psychiatrical
- Compulsive Disorder
Now we recognize subcortical dementia and obsessive-compulsive disorder is due to basal ganglia lesions. Similarly, by analogy we should give more attention to the cerebellum for cognition and behavior. [ijpm.info]
- Grandiose Ideas
He was euphoric and was expressing grandiose ideas. Bender Gestalt Test showed signs of organicity. Score in Young mania relating scale was 32; productivity was low in Rorschach. [ijpm.info]
Neurologic
- Ataxia
MRI data showed that patients with larger infarct volumes had a significantly more severe ataxia. In patients with ataxia of stance, gait and lower limbs lesions were more common in cerebellar lobules IV to VI. [ncbi.nlm.nih.gov]
Genetic: there are a number of inherited cerebellar ataxias: Many of these present in adulthood. Examples are Friedreich's ataxia (the most common) and ataxia telangiectasia. Metabolic and endocrine: Cerebral oedema of chronic hypoxia. [patient.info]
- Vertigo
Remaining 8 patients were also symptomatic for vertigo, but they had spontaneous nystagmus. The latter group was called "disease control." [ncbi.nlm.nih.gov]
[…] overlap with cerebellar stroke, and approximately 0.7-3% of isolated vertigo have cerebellar stroke. [longdom.org]
Signs and symptoms of cerebellar stroke include: Vertigo* Vomiting Dizziness Lethargy Headache Muscle weakness or paralysis Vision problems (like blindness) *Vertigo is a huge one. [flintrehab.com]
- Nystagmus
We periodically observed spontaneous and positional nystagmus 6-24h after symptom onset. RESULTS: In three of the patients, the direction and/or type of nystagmus changed periodically. [ncbi.nlm.nih.gov]
In the author's experience, these patients often exhibit rebound nystagmus, which is a variant of gaze-evoked nystagmus. Some of these patients have upbeating nystagmus supine, often confused with BPPV. [dizziness-and-balance.com]
- Dysmetria
Andreason suggests the presence of cognitive dysmetria due to cerebellar involvement in schizophrenia which is analogous to motor dysmetria so far described in cerebellar patients. [4] Cerebral lesions producing Mania was described by many authors. [5 [ijpm.info]
During his admission to the stroke neurology unit, the patient suffered from ongoing significant ataxia, dysarthria, scanning speech, motor dysmetria, and mild diplopia. [cerebellumandataxias.biomedcentral.com]
Damage to the cerebellum can lead to: 1) loss of coordination of motor movement (asynergia), 2) the inability to judge distance and when to stop (dysmetria), 3) the inability to perform rapid alternating movements (adiadochokinesia), 4) movement tremors [neuroskills.com]
[…] ophthalmoplegia One and a half syndrome Midbrain (CN 3, 4) Weber's syndrome ventral peduncle, PCA Benedikt syndrome ventral tegmentum, PCA Parinaud's syndrome dorsal, tumor Nothnagel's syndrome Claude's syndrome Other Alternating hemiplegia Cerebellum lateral (Dysmetria [en.wikipedia.org]
- Unable to Walk
[…] to walk, and many also have direction-changing or gaze-evoked nystagmus, in which the direction of the nystagmus changes according to the patient’s gaze. 8 Neuronal tracts between the cerebellum and limbs are either doubly crossed or uncrossed, so that [ahajournals.org]
Initially, she was able to hold objects with her right arm but walked with a dragging step. The weakness of her right limb progressed and she was unable to walk independently and hold chopsticks. [spandidos-publications.com]
Workup
[…] include incompatibility with certain medical equipment, longer imaging times (increased risk of motion artifact), and poor visualization of the subarachnoid space Neither CT nor MRI can be used to differentiate tumor recurrence from radionecrosis See Workup [emedicine.medscape.com]
Given the patient’s neuroimaging findings and the results of the medical workup, we reached the diagnosis of a psychotic disorder due to a remote cerebellar stroke on the basis of the patient’s time course, history of delusions and disorganized behavior [neuro.psychiatryonline.org]
We are reporting a toddler child who has been found to have evidence of cerebellar rather than cerebral stroke after interesting clinical presentation & appropriate workup. Case Report We are reporting R.A, a previously healthy 4 ½ years old. [clinmedjournals.org]
Blocks
- Left Anterior Fascicular Block
Lipid Panel: Chol: 227 | Trigl: 149 | HDL: 43| LDL: 160 | HgbA1c: 11.4 BMP normal, glucose: 324mg/dl | CBC: normal INR: 1.1 EKG: Normal sinus rhythm, Left anterior fascicular block Telemetry monitoring without remarkable events 5. [slideshare.net]
Treatment
To the best of our knowledge, PFS due to cerebellar stroke has only been reported in patients who also underwent surgical treatment of the underlying vascular cause. [ncbi.nlm.nih.gov]
Before we dig in, let’s quickly discuss treatment. Cerebellar Stroke Treatment Treatment for cerebellar stroke depends on the type of stroke: ischemic or hemorrhagic. [flintrehab.com]
Published on Jan 22, 2014 Brief presentation of medical and surgical treatment options for massive cerebellar stroke. [slideshare.net]
Prognosis
The Relationship Between Clinical Status, Computed Tomography and Prognosis in Spontaneous Intracerebral Hematomas. Tepecik Eğit Hast Derg. 1992; 2(1): 41-48 [tepecikdergisi.com]
Prognosis Nancy has shown good improvement and is returning home with extra caregivers to help her. She has shown good recovery and her prognosis has improved. [study.com]
We therefore aim to discuss the clinical presentation, treatment, causes, and prognosis of cerebellar stroke in both adults and children. Important differences between children and adults are discussed after each section. [ncbi.nlm.nih.gov]
Strangely enough, the development of complications did not serve to worsen patient prognosis; prognosis mainly depended on the number of affected territories and the presence of brainstem impairment.Conflicts of interest The authors have no conflicts [elsevier.es]
Their management often requires surgical intervention, and the prognosis is usually good when the intervention is performed before the patient becomes comatose. [medlink.com]
Etiology
Posterior fossa syndrome (PFS) due to vascular etiology is rare in children and adults. [ncbi.nlm.nih.gov]
The main etiology in PICA was cardioembolism. [annalsofian.org]
Outline: • Introduction • Patient history • Symptoms and signs • Etiology and pathogenesis • Imaging • Differential diagnosis • Complication • Management • Summary 3. [slideshare.net]
The constellation of findings was therefore highly supportive of a vascular etiology. [neuro.psychiatryonline.org]
Epidemiology
Stroke for the 21st Century and on behalf of the American Heart Association Stroke Council, Council on Cardiovascular Surgery and Anesthesia, Council on Cardiovascular Radiology and Intervention, Council on Cardiovascular and Stroke Nursing, Council on Epidemiology [ahajournals.org]
Epidemiology As a general rule, brain tumors increase in frequency with age, with individual exceptions (e.g. pilocytic astrocytoma, the vast majority of which are found in young patients), and a number of uncommon tumors found in infancy (see brain tumors [radiopaedia.org]
Epidemiology, clinical manifestations, and diagnosis of brain metastases. https://www.uptodate.com/home. Accessed April 18, 2017. Metastatic cancer. National Cancer Institute. http://www.cancer.gov/cancertopics/factsheet/Sites-Types/metastatic. [mayoclinic.org]
We recorded the following epidemiological variables from each patient: sex, age, presence of cardiovascular risk factors (smoking, high blood pressure, diabetes mellitus, dyslipidaemia, presence of cardioembolism) and aetiology (TOAST criteria18). [elsevier.es]
With obvious literature shortage, the need for more epidemiological studies is well clarified. References Barinagarrementeria F, Amaya LE, Cantu C (1997) Causes and mechanisms of cerebellar infarction in young patients. Stroke 28: 2400-2404. [clinmedjournals.org]
Pathophysiology
A decrease of excitatory impulses from the lesioned cerebellum to the structurally intact supratentorial network subserving cognitive, behavioural and affective processes constitutes the likely pathophysiological mechanism underlying PFS and CCAS in this [ncbi.nlm.nih.gov]
Moreover, a better understanding of the pathophysiological mechanisms underlying the presence of post-stroke mood disorders could improve their management. [clinicaltrials.gov]
For example, schizophrenia has alternatively been described, pathophysiologically, as a “cognitive dysmetria” due to dysfunction in the cortico-cerebello-thalamo-cortical circuit [ 5 ]. [cerebellumandataxias.biomedcentral.com]
Prevention
In both patient groups, it is often unclear at what point surgical intervention should be considered either to prevent further neurologic deterioration or to try to salvage a meaningful neurologic recovery. [mayoclinic.pure.elsevier.com]
Management of cerebellar stroke is aimed at preventing rapid deterioration and reversing the lost functions as much as possible so that patient can live normal lifestyle. [tandurust.com]
Then steps are taken to prevent and treat complications. This is followed by rehabilitation to return the patient to optimum recovery. Lifestyle changing techniques are provided to prevent subsequent strokes. [livestrong.com]
Management or prevention of these conditions can significantly decrease your risk of stroke. [winchesterhospital.org]