Emergency: requires immediate attention
Cerebellar stroke
Alerts and Notices
Synopsis

- Ischemic cerebellar strokes are predominantly either thrombotic or embolic. Thrombotic strokes are often caused by atherosclerosis, while embolic strokes are commonly cardiogenic (atrial fibrillation), septic, or due to coagulopathy.
- Hemorrhagic strokes can be intraparenchymal, due to hypertension, or secondary to subdural or subarachnoid hemorrhage.
Risk factors for cerebellar strokes are the same as for other cerebrovascular pathologies: hypertension, hyperlipidemia, diabetes, cardioembolic risks such as atrial fibrillation, and tobacco abuse are chief among them. Cerebellar hemorrhages can also be caused by a rupture of vascular malformations; hereditary hemorrhagic telangiectasia (HHT) is a particular risk factor. Rupture of vascular malformations is a more likely cause in children. Other risk factors for cerebellar hemorrhages include sympathomimetic abuse such as cocaine use. Increased urinary sodium is associated with increased risk.
Related topic: drug-induced stroke
Codes
ICD10CM:G46.4 – Cerebellar stroke syndrome
SNOMEDCT:
195213000 – Cerebellar stroke syndrome
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Cerebellar mass
- Metastasis
- Peripheral vertigo (eg, benign paroxysmal positional vertigo)
- Basilar migraine headache
- Acute demyelinating encephalomyelitis
- Multiple sclerosis
- Meningitis (eg, viral, bacterial, fungal)
- Guillain-Barré syndrome variants, eg, Miller Fisher syndrome, Bickerstaff encephalitis
- Hypoglycemia or metabolic derangements
- Alcohol intoxication (see alcohol use disorder)
- Wernicke encephalopathy
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Management Pearls
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Therapy
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References
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Last Reviewed:10/26/2017
Last Updated:04/03/2023
Last Updated:04/03/2023