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Neuroradiology

Infarction, cerebellar

results from occlusion of one of the major branches to the cerebellum superior or middle cerebellar arteries or posterior inferior cerebellar artery (PICA), or following occlusion of the basilar artery. Infarcts of the cerebellum may be small or large; the size is important because clinically a small infarct may be well tolerated and resolve spontaneously, while a large infarct causes oedema, compression of the fourth ventricle and supratentorial hydrocephalus. The hydrocephalus itself and the brain stem compression may be responsible for severe worsening of the clinical conditions within the first 24 - 48 hours. Patients should be closely monitored so that a a temporary shunt of the ventricular system can be installed if necessary. CT ( Fig.1) and MR (Fig.2) show the infarcted area (see infarction cerebral); cortical gyral enhancement may be present.

 

GS

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Fig.1

a, b. Acute cerebellar infarction. CT scan without contrast performed six hours from stroke: hypodensity of the right cerebellar hemisphere involving both cortex and white matter. c, d. 24 hours later marked supratentorial hydrocephalus develops. The patient has been shunted and the posterior fossa mass effect has resolved within ten days.
Infarction, cerebellar, Fig.1 (a)
Infarction, cerebellar, Fig.1 (b)
Infarction, cerebellar, Fig.1 (c)
Infarction, cerebellar, Fig.1 (d)
Infarction, cerebellar, Fig.2 (a)
Infarction, cerebellar, Fig.2 (b)