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Cerebellar Stroke
Presentation
- Posterior circulation stroke presents similarly in children and adults. However, the possibly mild symptoms and signs at onset are frequently overlooked by parents and also by healthcare professionals.[ncbi.nlm.nih.gov]
- The clinical presentation may be ambiguous, and initial computed tomography scan can be normal.[ncbi.nlm.nih.gov]
- 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.[doi.org]
- At stage 1, hypermetria was present in the basal state and was not modified by the addition of inerital loads. At stage 2, hypermetria, which was present in the basal state, was enlarged by mass addition.[ncbi.nlm.nih.gov]
Entire Body System
Hunting
- Moreover, yoga exercises, bow hunting and cervical trauma have all been associated with vertebra-basilar damage and subsequent stroke due to cerebellar infarction.[clinmedjournals.org]
Cardiovascular
Venous Insufficiency
- Aortic arch syndrome (Medical Encyclopedia) Arterial embolism (Medical Encyclopedia) Arteriogram (Medical Encyclopedia) Cerebral angiography (Medical Encyclopedia) Duplex ultrasound (Medical Encyclopedia) Venous insufficiency (Medical Encyclopedia) Venous[icdlist.com]
Eyes
Kayser-Fleischer Ring
- There was no Kayser-Fleischer ring. He is born to non-consanguineous parents. He is the first of three siblings. There was no positive past or family history of mental illness or neurological complaints.[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]
- This continued to a mild extent and then worsened 10 days later, with a brief episode of right hemi-numbness, right ear tinnitus, poor balance, and incoordination of the right hand that persisted.[doi.org]
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]
- Eighteen patients with isolated cerebellar stroke (13 males, 5 females; 20-66 years old) were evaluated using measures of ataxia and neurocognitive ability.[ncbi.nlm.nih.gov]
- CONCLUSIONS: In the acute stage, arm movements were mainly characterized by abnormal slowness (bradykinesia) and not dyscoordination (ataxia).[ncbi.nlm.nih.gov]
- Furthermore, acute cerebellar ataxia was not associated with a loss of the common drive.[ncbi.nlm.nih.gov]
- RESULTS: Initial neurological and functional scores were similar among all the groups with vertigo, nausea, unsteadiness, and limb ataxia being the most common. Infarct volume, vascular territories, and comorbidity did not predict clinical outcome.[ncbi.nlm.nih.gov]
Vertigo
- In four of the patients, severe vertigo, nausea, and vomiting persisted after the nystagmus had been resolved.[ncbi.nlm.nih.gov]
- Remaining 8 patients were also symptomatic for vertigo, but they had spontaneous nystagmus. The latter group was called "disease control."[ncbi.nlm.nih.gov]
- A case is reported of a 72-year-old woman who presented with severe vertigo, vomit, and mild neck and occipital pain.[ncbi.nlm.nih.gov]
- RESULTS: Initial neurological and functional scores were similar among all the groups with vertigo, nausea, unsteadiness, and limb ataxia being the most common. Infarct volume, vascular territories, and comorbidity did not predict clinical outcome.[ncbi.nlm.nih.gov]
- Vertigo of vascular origin. Clinical and electronystagmographic features in 84 cases. Arch Neurol. 1989; 46 :281–284. [ PubMed ] 2. Fisher CM. Vertigo in cerebrovascular disease. Arch Otolaryngol. 1967; 85 :529–534. [ PubMed ] 3. Troost BT.[ncbi.nlm.nih.gov]
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]
- Remaining 8 patients were also symptomatic for vertigo, but they had spontaneous nystagmus. The latter group was called "disease control."[ncbi.nlm.nih.gov]
- 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]
- 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]
- There was no nystagmus. Neurologic examination revealed incordinate movements which affected her right side: deep tendon reflexes were brisk in all four extremities.[nature.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]
- Case Description A community-dwelling female participant (aged 81 years, height 1.60 m, mass 62.1 kg, Rivermead Gross Motor Function 10, Fugl-Meyer lower limb score 31 with slight dysmetria observed, International Cooperative Ataxia Rating Scale for gait[frontiersin.org]
- Finger-nose and heel-knee-shin tests will demonstrate even mild limb ataxia, with terminal intention tremor and dysmetria (past pointing). Acute-onset ataxia Either due to cerebellar haemorrhage or infarction.[patient.info]
Decerebrate Posturing
- There was no motor response except decerebrate posturing of the right arm. A right frontal ventriculostomy and a suboccipital craniotomy with posterior fossa clot evacuation were performed.[doi.org]
Workup
- 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]
Microbiology
Chlamydia
- A wide range of organisms including viruses, bacteria, mycoplasma & chlamydia are thought to be involved.[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
- KEYWORDS: adults; cerebellar stroke; children; hemorrhage; ischemia; outcome; treatment[ncbi.nlm.nih.gov]
- 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]
- Current treatment options in the intensive care unit are additionally discussed.[ncbi.nlm.nih.gov]
- Other treatments include medicines and surgery.[icdlist.com]
- Treatment of hypertensive cerebellar hemorrhage: surgical or conservative management? Neurosurgery 1994;34246- 251 PubMed Google Scholar Crossref 13.[doi.org]
Prognosis
- 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]
- 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]
- CONCLUSIONS: The study shows that the rehabilitation prognosis of cerebellar stroke is affected by the presence of extracerebellar stroke lesions.[ncbi.nlm.nih.gov]
- Space-occupying cerebellar infarction: clinical course and prognosis. Stroke. 1994 ; 25 :372–374. Crossref Medline Google Scholar 8 Macdonell RAL, Kalnins RM, Konnan GA. Cerebellar infarction: natural history, prognosis and pathology.[stroke.ahajournals.org]
Etiology
- Posterior fossa syndrome (PFS) due to vascular etiology is rare in children and adults.[ncbi.nlm.nih.gov]
- 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]
- The main etiologies of cerebellar stroke are artery-to-artery embolism and cardioembolism, followed by in situ branch atherosclerosis.[link.springer.com]
- The role of the cerebellum in cognition and behavior is gaining more and more importance now. [1] Faulty cerebellar circuits are implicated in the etiology of schizophrenia.[ijpm.info]
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]
- 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]
- Clinico-epidemiologic study of stroke in Akita, Japan. Stroke. 1987; 18 :402–6. [ PubMed ] 4. Kim CH, Kim JS. Development of cerebral infarction shortly after intracerebral hemorrhage. Eur Neurol. 2007; 57 :145–9. [ PubMed ] 5.[ncbi.nlm.nih.gov]
- . [4] Epidemiologic studies indicate that 82–92% of strokes in the United States are ischemic.[emedicine.medscape.com]
Sex distribution
Age distribution
Pathophysiology
- Whichever the pathophysiological mechanisms involved, our results demonstrate that the cerebellum dysfunction plays a role in the abnormalities of CMCT elicited by TMS.[ncbi.nlm.nih.gov]
- 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]
- Although the clinical syndromes, complications, and underlying pathophysiological mechanisms have been well characterized, 1 4 5 fewer data are available concerning outcome after acute cerebellar stroke.[stroke.ahajournals.org]
Prevention
- 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]
- 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]
- Guideline for the prevention of stroke in women. Available at: ...(Click grey area to select URL) Accessed November 18, 2015. 6/2/2014 DynaMed's Systematic Literature Surveillance ... : Myint PK, Cleark AB, Kwok CS, et al.[health.cvs.com]
- 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.[ncbi.nlm.nih.gov]