title: Prognostic Importance of Lesion Location on Functional Outcome in Patients with Cerebellar Ischemic Stroke: a Prospective Pilot Study.
abstract: To date, few studies focused on prediction of functional recovery after cerebellar stroke. The main aim of this prospective pilot study was to determine the association between cerebellar lesion location and functional outcome in adults with acute cerebellar infarction. We examined 14 patients with first-ever unilateral cerebellar ischemic stroke within 7 days and at 90 days from the onset of stroke by means of the International Cooperative Ataxia Rating Scale. Cerebellar lesions were traced from magnetic resonance imaging performed within 72 h since stroke and region of interest were generated. The association between the International Cooperative Ataxia Rating Scale score and lesion location was determined with the voxel-based lesion-symptom mapping methods implemented in the MRIcro software. Colored lesion-symptom maps representing the z statistics were generated and overlaid onto the MNI-ICBM 152 linear probabilistic atlas of the human brain and the Johns Hopkins University white matter templates. Our results documented that injuries to the V, VI, VIIA Crus I, VIIA Crus II, VIIB, VIIIA, and VIIIB lobules and the middle cerebellar peduncle are significantly associated with the International Cooperative Ataxia Rating Scale (ICARS) score at 1 week after the onset of stroke. Furthermore, we found that injuries to the VI, VIIA Crus I, VIIA Crus II, VIIB, VIIIA, and VIIIB lobules, the dentate nucleus, and the middle cerebellar peduncle are significantly associated with the ICARS score at 3 months since the cerebellar stroke onset. The findings of this pilot study might improve prognostic accuracy of functional outcome in patients with acute cerebellar infarction.
authors.affiliation: Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurological, Biomedical and Movement Sciences, University of Verona, Italy. P.le L.A. Scuro, 10, 37134, Verona, Italy. alessandro.picelli@univr.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Picelli
authors.affiliation: Physical Medicine and Rehabilitation Unit, "Villa Salus" Hospital, Venice, Mestre, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Zuccher
authors.affiliation: Stroke Unit, Division of Neurology, Department of Neurosciences, Hospital Trust of Verona, Verona, Italy.
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Tomelleri
authors.affiliation: Stroke Unit, Division of Neurology, Department of Neurosciences, Hospital Trust of Verona, Verona, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Bovi
authors.affiliation: Division of Neurology, Department of Neurosciences, Hospital Trust of Verona, Verona, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Moretto
authors.affiliation: Department of Neurological Rehabilitation, "Villa Melitta" Private Hospital, Bolzano, Italy.|Research Department for Neurorehabilitation South Tyrol, Bolzano, Italy.
authors.forename: Andreas
authors.initials: A
authors.lastname: Waldner
authors.affiliation: Research Department for Neurorehabilitation South Tyrol, Bolzano, Italy.|Department of Neurology, Hochzirl Hospital, Zirl, Austria.
authors.forename: Leopold
authors.initials: L
authors.lastname: Saltuari
authors.affiliation: Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurological, Biomedical and Movement Sciences, University of Verona, Italy. P.le L.A. Scuro, 10, 37134, Verona, Italy.|Neurorehabilitation Unit, Department of Neurosciences, Hospital Trust of Verona, Verona, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Smania
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D002531:Cerebellum / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D007839:Functional Laterality; D006801:Humans; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D010865:Pilot Projects; D011379:Prognosis; D011446:Prospective Studies; D020127:Recovery of Function; D020521:Stroke / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D016896:Treatment Outcome
keywords: Ataxia; Cerebellum; Early diagnosis; Infarction; Prognosis