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Frequency and clinical significance of acute bilateral cerebellar infarcts.

Authors
Hong, JM; Bang, OY; Chung, CS; Joo, IS; Huh, K
Citation
Cerebrovascular diseases (Basel, Switzerland), 26(5):541-548, 2008
Journal Title
Cerebrovascular diseases (Basel, Switzerland)
ISSN
1015-97701421-9786
Abstract
BACKGROUND: Unlike acute unilateral cerebellar infarct (UCI), acute bilateral cerebellar infarcts (BCI) have attracted little attention. To evaluate the clinical significance of BCI, we compared UCI and BCI and analyzed potentially prognostic factors. METHODS: Patients who were consecutively admitted at a university hospital over a 4-year period with acute cerebellar infarcts, proven by diffusion-weighted imaging, were studied. Cerebellar infarcts were topographically classified, and divided into 2 groups: UCI and BCI. The demographics, involved territories, concomitant lesions outside the cerebellum (CLOC), bilateral involvement, infarct volume, hospital courses, and mechanisms were analyzed. We performed multiple regression analysis to predict the poor outcome at discharge [> or =3 on the modified Rankin Scale (mRS)]. RESULTS: Among 162 patients with acute cerebellar infarcts, 31% (n = 50) were BCI. Territorial infarcts were 74% (n = 120) and non-territorial infarcts 26% (n = 42) of the total. Posterior inferior cerebellar artery infarcts were the most common, and combined-territorial infarcts were the rarest. Baseline demographics were not significantly different between UCI and BCI, except for initial stroke severity (modified NIH Stroke Scale and infarct volume) and diabetes. Large-artery atherosclerosis was significantly higher in BCI, whereas undetermined causes were higher in UCI (p = 0.028). By multiple regression analysis, BCI was the only independent radiological factor for poor prognosis (odds ratio, 6.96; 95% CI, 1.80-26.92), and represented a significantly more unstable hospital course, longer hospital stay, worse mRS at discharge, and higher mortality. CONCLUSIONS: In acute cerebellar infarcts, bilateral involvement is common and appears to be a superior determinant for early prognosis rather than territories involved or CLOC.
MeSH terms
Acute DiseaseAgedAngiography, Digital SubtractionCerebellum/blood supply*Cerebral AngiographyCerebral Infarction*/etiologyCerebral Infarction*/mortalityCerebral Infarction*/pathologyCerebral Infarction*/therapyDiffusion Magnetic Resonance ImagingFemaleHumansLength of StayMagnetic Resonance AngiographyMaleMiddle AgedOdds RatioRisk AssessmentRisk FactorsSeverity of Illness IndexTime FactorsTreatment Outcome
DOI
10.1159/000160211
PMID
18836265
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Journal Papers > School of Medicine / Graduate School of Medicine > Neurology
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