![]() Diffusion-weighted imaging (DWI) is highly sensitive in detecting ischemic changes in the subacute stage of stroke. Also, brain computed tomography (CT) is less accurate in detecting an ischemic lesion in the first hours. Clinical manifestations in the acute stage are very nonspecific, an isolated vertigo may mimic acute peripheral vestibular disorders or a brainstem lesion. The risk factors for cerebellar stroke are the same as for strokes in other areas of the brain. It is common between the fifth and eighth decades of life, with men aged 60 to 65 being affected more often than women. Ischemic cerebellar infarction is a rare condition and accounts for between 1.5 % and 20 % of all ischemic strokes. Cardioembolic etiology, location of the ischemic lesion, and pyramidal signs support a negative prognosis. The TOAST classification is less useful in assessing supratentorial ischemic infarcts. Mortality was higher among patients with ischemic lesion caused by cardiac sources ( p = 0.00094) and with pyramidal signs ( p = 0.00640). Pyramidal signs occurred in 29/107 of patients and were more prevalent when the lesion was distributed in more than two vascular regions ( p = 0.00640). According to the TOAST classification, stroke was more prevalent in atrial fibrillation (26/107) and when the lesion was in the PICA territory (39/107). We studied the clinical features and compared them based on the location of the ischemic lesion and its distribution in the posterior interior cerebellar artery (PICA), superior cerebellar artery (SCA), and anterior inferior cerebellar artery (AICA) territories. We retrospectively analyzed 107 patients with diagnosed ischemic cerebellar infarction. #Wallenburg pica syndrome step 1 trialThe aim of this study was to assess the usefulness of the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification in cerebellar stroke and the impact of clinical features on the prognosis. The symptoms in the acute phase could imitate acute peripheral vestibular disorders or a brainstem lesion. First descriptions by Wallenberg were in 1895 (clinical) and 1901 (autopsy findings).Cerebellar stroke is a rare condition with very nonspecific clinical features. This syndrome was first described in 1808 by Gaspard Vieusseux. Others may be left with significant neurological disabilities for years after the initial symptoms appeared. Some individuals may see a decrease in their symptoms within weeks or months. The outlook for someone with lateral medullary syndrome depends upon the size and location of the area of the brain stem damaged by the stroke. Some doctors report that the anti-epileptic drug gabapentin appears to be an effective medication for individuals with chronic pain. In some cases, medication may be used to reduce or eliminate pain. Speech/swallowing therapy may be beneficial. A feeding tube may be necessary if swallowing is very difficult. Treatment for lateral medullary syndrome is symptomatic. Onset is usually acute with severe vertigo. ![]() Nystagmus and vertigo, which may result in falling, caused from involvement of the region of Deiters' nucleus and other vestibular nuclei. The damage to the cerebellum or the inferior cerebellar peduncle can cause ataxia. The spinothalamic tract is damaged, resulting in loss of pain and temperature sensation to the opposite side of the body. Damage to the spinal trigeminal nucleus causes absence of pain on the ipsilateral side of the face, as well as an absent corneal reflex. The affected persons have difficulty in swallowing ( dysphagia) resulting from involvement of the nucleus ambiguus, and slurred speech ( dysphonia, dysarthria). The cause of this syndrome is usually the occlusion of the posterior inferior cerebellar artery (PICA) at its origin. Other clinical symptoms and findings are ataxia, facial pain, vertigo, nystagmus, Horner's syndrome, diplopia and dysphagia. This syndrome is characterized by sensory deficits affecting the trunk and extremities on the opposite side of the infarct and sensory and motor deficits affecting the face and cranial nerves on the same side with the infarct. Nucleus ambiguus (which affects vagus X and glossopharyngeal nerves IX)ĭysphagia, hoarseness, diminished gag reflexĪn affected person may present with ataxia on the side of lesion. Ipsilateral loss of pain and temperature sensation from face Lateral medullary syndrome presents with the following symptoms:Ĭontralateral deficits in pain and temperature sensation from body It is the clinical manifestation resulting from occlusion of the posterior inferior cerebellar artery (PICA) or one of its branches or of the vertebral artery, in which the lateral part of the medulla oblongata infarcts, resulting in a typical pattern. ![]()
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