Bilateral infarcts in the territory of the superior cerebellar artery: clinical presentation, presumed cause, and outcome.
OBJECTIVE
The aim of this study was to document the clinical presentation, vascular topographic patterns, stroke mechanism, and outcome of bilateral infarcts in the territory of the superior cerebellar artery (SCA) based on data collected from a prospective acute stroke registry.


METHODS
We studied the clinical and radiological features of 11 patients with bilateral infarctions in the territory of the SCA diagnosed by brain MRI.


RESULTS
Bilateral SCA infarcts represented 23.4% (11/47) of all SCA territory infarction. Bilateral SCA infarcts mostly associated with brainstem (n = 5), cerebral (n = 5), or non-SCA cerebellar lesions (n = 4). The most common clinical presentation at onset was sudden fall with axial lateropulsion and dysarthria (n = 6). In five patients with a coexisting infarct(s) in the brainstem, limb weakness and/or mental change were prominent and often masked the signs of cerebellar dysfunction. Six patients showed no stenosis or occlusion in the vertebrobasilar system on brain MRA. Five had an obvious cardiac source of emboli. Eight patients showed favorable outcomes with complete recovery or minimal disability, but three patients with additional extensive brainstem infarcts died within 1 week.


CONCLUSIONS
Bilateral SCA territory infarcts show variable clinical, vascular topographic, and prognostic features. They usually result from cardiac emboli.
Department of Neurology, Keimyung University School of Medicine, Daegu, South Korea.
Hyun-Ah
HA
Kim
Hyung
H
Lee
Sung-Il
SI
Sohn
Hyon-Ah
HA
Yi
Yong-Won
YW
Cho
Seong-Ryong
SR
Lee
Byung-Rim
BR
Park
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002531:Cerebellum / Q000098:blood supply / Q000473:pathology*; D002544:Cerebral Infarction / Q000209:etiology / Q000473:pathology* / Q000628:therapy; D002560:Cerebrovascular Circulation / Q000502:physiology; D018450:Disease Progression; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000209:etiology / Q000473:pathology* / Q000628:therapy; D016896:Treatment Outcome