Misdiagnosis of cerebellar infarctions.
BACKGROUND
This retrospective study addresses for the first time the differences in clinical features and outcomes between those individuals with a cerebellar infarct who were correctly diagnosed on initial presentation compared to those who experienced delayed diagnosis.


METHODS
A retrospective review was conducted of our stroke registry from 09/2003 to 02/2011. Forty seven patients had an isolated cerebellar infarction confirmed by MRI. Misdiagnosis was defined as the diagnosis given by the first physician.


RESULTS
Among 47 patients identified, 59.6% had delayed diagnosis. Five patients in the correct diagnosis group received intravenous tissue plasminogen activator, compared to none in the delayed diagnosis group. Complaints of weakness were protective from delayed diagnosis (OR 0.087, 95% CI 0.019-0.393, p=0.001). Conclusion : Patients with an isolated cerebellar infarction need to be considered when patients present with acute non-specific symptoms. Critical components of the neurological examination are omitted which are imperative to diagnose cerebellar infarcts. A thorough neurological examination may increase clinical suspicion of an ischemic stroke.
1Department of Neurology,Kaiser Permanente,Los Angeles Medical Center,Los Angeles,California.
Navdeep
N
Sangha
2Department of Epidemiology,School of Public Health,University of Alabama at Birmingham.
Karen C
KC
Albright
5Stroke Center,Department of Neurology,University of Texas Health Science Center at Houston,Houston,Texas.
Hui
H
Peng
Farhaan
F
Vahidy
2Department of Epidemiology,School of Public Health,University of Alabama at Birmingham.
Amelia
A
Boehme
5Stroke Center,Department of Neurology,University of Texas Health Science Center at Houston,Houston,Texas.
Zhongxue
Z
Chen
5Stroke Center,Department of Neurology,University of Texas Health Science Center at Houston,Houston,Texas.
Sean I
SI
Savitz
D000328:Adult; D000368:Aged; D020526:Brain Stem Infarctions / Q000175:diagnosis* / Q000188:drug therapy; D002531:Cerebellum / Q000473:pathology*; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage
D010959:Tissue Plasminogen Activator