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Emergency: requires immediate attention
Cerebellar stroke
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Other Resources UpToDate PubMed
Emergency: requires immediate attention

Cerebellar stroke

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Contributors: Jamie Adams MD, Richard L. Barbano MD, PhD
Other Resources UpToDate PubMed

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Synopsis

Cerebellar stroke : Dizziness, Headache, Nausea, Vomiting, Ataxia, Nystagmus, Vertigo, Drowsiness, Slurred speech
A cerebellar stroke involves ischemia or hemorrhage of the cerebellum. Symptoms are typically acute in onset and include ataxia (imbalance, coordination problems), vertigo, dysarthria, nausea, vomiting, dizziness, and headache. There may be a decreased level of consciousness, abnormal breathing, and brain stem signs as well. There are several named syndromes characterized by location of the stroke and resulting symptoms. Prognosis depends on the location and size of the stroke as well as timely evaluation and treatment.
  • 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.
Cerebellar stroke carries a higher mortality than many other forms of stroke due to the cerebellum's proximity to the brain stem, which may share vascular territory or be compressed by cerebellar edema, potentially leading to coma and death.

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

Best Tests

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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
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Emergency: requires immediate attention
Cerebellar stroke
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A medical illustration showing key findings of Cerebellar stroke : Dizziness, Headache, Nausea, Vomiting, Ataxia, Nystagmus, Vertigo, Drowsiness, Slurred speech
Imaging Studies image of Cerebellar stroke - imageId=7903644. Click to open in gallery. caption: '<span>Diffusion weighted imaging demonstrates increased signal in the left cerebellum. There was a corresponding decrease in the ADC map, consistent with acute left cerebellar infarction.</span>'
Diffusion weighted imaging demonstrates increased signal in the left cerebellum. There was a corresponding decrease in the ADC map, consistent with acute left cerebellar infarction.

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