Clinical Analysis of Cerebellar Infarctions Diagnosed via the Emergency Department

ABSTRACT

PURPOSE: Diagnosis of a cerebellar infarct without signs such as weakness, ataxia, or focal neurologic findings is difficult. This study used a clinical review of cerebellar infarctions for the purpose of accurately diagnosing and properly managing such patients. METHODS: We retrospectively studied 94 cerebellar infarct patients who had been admitted to the university hospital via the emergency department from May 1995 to March 2001. We reviewed clinical records and radiologic findings and analyzed risk factors of cerebrovascular disease, chief complaints and associated symptoms, neurologic examinations, electrocardiograms, and brain CT and/or brain MRI findings. RESULTS: Fifty-four (57.4%) of the patients were men and forty (42.6%) were women, and their mean age was 64.1+/- 13.0 years. The most frequent risk factor was hypertension (55.3%), and others were diabetes mellitus (26.6%), cerebrovascular disease (17.0%), ischemic heart disease (10.6%), and atrial fibrillation (6.4%). As to the involved territory, 54 (57.4%) posterior inferior cerebellar artery infarcts, 15 (16.0%) superior cerebellar artery infarcts, 3 (3.2%) anterior inferior cerebellar artery infarcts, and 19 (20.2%) combined-territory infarcts were found. As for symptoms and signs, vertigo (69.1%) and nausea and/or vomiting (64.9%) were the most frequent others were dysarthria (38.3%), headache (37.2%), ataxia (43.6%), motor weakness (38.3%), nystagmus (30.9%), and so on. Especially, seven (7.4%) patients showed isolated vertigo without paralysis, weakness, or ataxia. CONCLUSION: Vertigo, nausea, and vomiting were frequent clinical findings in 94 cerebellar infarct patients. Nine of these patients showed isolated vertigo. The posterior inferior cerebellar artery was the most frequently involved territory.