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Clinical Manifestations of Cerebellar Infarction According to Specific Lobular Involvement

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Abstract

Lesions in the cerebellum produce various symptoms related to balance and motor coordination. However, the relationship between the exact topographical localization of a lesion and the resulting symptoms is not well understood in humans. In this study, we analyzed 66 consecutive patients with isolated cerebellar infarctions demonstrated on diffusion-weighted magnetic resonance imaging. We identified the involved lobules in these patients using a cross-referencing tool of the picture archiving and communication system, and we investigated the relationships between the sites of the lesions and specific symptoms using χ 2 tests and logistic regression analysis. The most common symptoms in patients with isolated cerebellar infarctions were vertigo (87%) and lateropulsion (82%). Isolated vertigo or lateropulsion without any other symptoms was present in 38% of patients. On the other hand, limb ataxia was a presenting symptom in only 40% of the patients. Lateropulsion, vertigo, and nystagmus were more common in patients with a lesion in the caudal vermis. Logistic regression analysis showed that lesions in the posterior paravermis or nodulus were independently associated with lateropulsion. Lesions in the nodulus were associated with contralateral pulsion, and involvement of the culmen was associated with ipsilateral pulsion and isolated lateropulsion without vertigo. Nystagmus was associated with lesions in the pyramis lobule, while lesions of the anterior paravermis were associated with dysarthria and limb ataxia. Our results showed that the cerebellar lobules are responsible for producing specific symptoms in cerebellar stroke patients.

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Acknowledgment

This work was supported by a grant from the Korea Healthcare Technology Research and Development Project, Ministry for Health, Welfare and Family Affairs, Republic of Korea (A085136).

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The authors report no conflicts of interests.

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Authors and Affiliations

  1. Department of Neurology, Yonsei University College of Medicine, 250 Seongsanno, Seoul, 120-752, South Korea

    Byoung Seok Ye, Young Dae Kim, Hyo Suk Nam & Ji Hoe Heo

  2. Department of Biostatistics, Yonsei University College of Medicine, 250 Seongsanno, Seoul, 120-752, South Korea

    Hye Sun Lee & Chung Mo Nam

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  1. Byoung Seok Ye
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  2. Young Dae Kim
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  4. Hye Sun Lee
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Correspondence to Ji Hoe Heo.

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Table e-1

Cerebellar lobules with concurrent tendency (DOC 50 kb)

Table e-2

Differences in symptoms/signs according to locations of cerebellar lesions (DOC 102 kb)

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Ye, B.S., Kim, Y.D., Nam, H.S. et al. Clinical Manifestations of Cerebellar Infarction According to Specific Lobular Involvement. Cerebellum 9, 571–579 (2010). https://doi.org/10.1007/s12311-010-0200-y

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