MRI mismatch-based intravenous thrombolysis for isolated cerebellar infarction.
OBJECTIVE
Cerebellar infarctions constitute a significant proportion of ischemic strokes and carry a substantial morbidity and mortality mainly because of swelling in the posterior fossa. No specific acute therapy is established, and patients are usually excluded from intravenous thrombolysis (IVT).


METHODS
Two patients presented in an extended time window of 5 and 7 hours to our emergency department with sudden onset of severe cerebellar symptoms. After emergency MRI demonstrated superior cerebellar artery (SCA) occlusion with hypoperfusion of the respective territory and only minor DWI lesions, IVT was administered. Both patients recovered within a few hours after therapy and follow-up MRI on day 1 after treatment demonstrated only minor infarction.


CONCLUSIONS
We present to our knowledge the first cases of MRI mismatch-based IVT in an extended time window in patients with isolated SCA-infarctions. More studies are needed to evaluate IVT in this patient population. Modern imaging techniques might be helpful to select patients for therapy in posterior circulation strokes.
Köhrmann
Martin
M
Department of Neurology, University of Erlangen, Erlangen, Germany. martin.koehrmann@uk-erlangen.de
Sauer
Roland
R
Huttner
Hagen B
HB
Engelhorn
Tobias
T
Doerfler
Arnd
A
Schellinger
Peter D
PD
D000368:Aged; D002526:Cerebellar Diseases / Q000473:pathology* / Q000628:therapy*; D002531:Cerebellum / Q000098:blood supply; D002533:Cerebral Angiography; D002536:Cerebral Arteries / Q000473:pathology; D002544:Cerebral Infarction / Q000473:pathology* / Q000628:therapy*; D002560:Cerebrovascular Circulation / Q000502:physiology; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007275:Injections, Intravenous; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D010477:Perfusion
D005343:Fibrinolytic Agents