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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.

 

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Fig.2

a. MRI, T2-weighted axial image. Hyperintensity involving mainly the superior surface of the right cerebellum. This is an infarction limited to the territory of the superior cerebellar artery, without mass effect and then without supratentorial hydrocephalus. b. T1-weighted coronal image, after intravenous injection of gadolinium (examination performed the fourth day after stroke): marked cortical enhancement.
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)