Chapter 41 - Cerebellar infarcts

Summary

The most common locations for cerebellar infarcts are the posterior inferior cerebellar artery (PICA) and superior cerebellar artery (SCA) territories and they are about equally involved. Cerebellar infarcts are often characterized by associated non-specific symptoms, transposing into clinical conditions difficult to diagnose. The clinical presentation of ischemia in the territories of the various cerebellar arteries depends on whether the ischemia affects only the cerebellum, only the brainstem, or a combination of brainstem and cerebellum. The most common symptoms are vertigo or dizziness, vomiting, abnormal gait, headache, and dysarthria. The SCA infarcts often provoke edema with brainstem compression and herniation of the cerebellar tonsils. Cerebellovestibular signs are prominent in patients with partial occlusion of the SCA territory. Dysarthria is a characteristic symptom of SCA territory infarction. Pseudotumoral infarcts are responsible for the development of increased pressure within the posterior fossa and intracranially and may mimick posterior fossa tumors.