Evaluation of cerebellar infarcts’ distrubution, clinical features and aetiological factors

Objective: Posterior circulation stroke syndromes are known to have high risk of mortality and morbidity. The recognition of posterior circulation infarcts are important for decreasing this mortality and morbidity, and can make it possible to administer thrombolysis treatment. In this study, our goal was to evaluate distribution of cerebellar infarcts, and to determine the clinical, aetiological and functional characteristics.
Material and Method: 90 patients were included in our study. All recorded vascular risk factors, blood pressure measurements, electrocardiograms, signs and symptoms during the application, results of cranial imaging and the results of studies done to reveal aethiology such as transthoracic ecocardiography and bilateral doppler ultrasonography of carotid arteries, cervical computed tomography or magnetic resonance angiography imaginings were examined.
Results: The most common vascular territories were medial posterior inferior cerebellar artery (PICA), medial superior cerebellar artery (SCA) and lateral PICA. Nausea and vomiting were the most common symptom, except for anterior inferior cerebellar artery (AICA). At AICA infarcts, it was derangement. The most common finding in all vascular territories were ataxia, dysmetria-disdiadokinezia and hypotonia. The
most common risk factors were hypertension (HT), smoking and diabetes mellitus. Cardioembolism was found in 22.2% and vertebrobasillar atherosclerosis (VBA) was found in 61.1% of the cases as aetiological factors. VBA was more common in infarcts that involved the territories of AICA, medial PICA and Iateral PICA. Cardioembolism was the most common in infarcts that involved the territories of medial SCA, Iateral
SCA and Iateral PICA.
Conclusions: In our study we found that the most commonly affected territory was medial PICA. The most common signs were nausea and vomiting, and the most common symptom was ataxia. HT was the predominant risk factor and the most common aetiological factor was VBA.

Serebellar infarktlarda damar alanlarýnýn daðýlýmý, klinik özellikleri ve etiyolojik faktörlerin deðerlendirilmesi

Amaç: Posterior dolaþým infarktlarý (PDÝ) yüksek mortalite ve morbidite riski taþýyan hastalýklar olarak bilinmektedir. PDÝ’larýnýn tanýnmasý bu mortalite ve morbiditenin azaltýlmasý ve tromboliz gibi yeni tedavi yaklaþýmlarýna olanak saðlamasý açýsýndan önemlidir. Bu çalýþmamýzda serebellar iskemik inmelerin damar alanlarýna göre daðýlýmýný, klinik, etiyolojik ve fonksiyonel karakteristiklerini araþtýrmayý amaçladýk.
Gereç ve Yöntem: Çalýþmamýza 90 hasta dahil edildi. Tüm hastalarýn kaydedilmiþ vasküler risk faktörleri, giriþ tansiyonlarý, elektrokardiyogram, kranial görüntüleme yöntemleri, baþvuru sýrasýndaki belirti ve nörolojik muayene bulgularý, etiyolojiyi saptamak amacýyla yapýlmýþ olan transtorasik ekokardiyografi, bilateral karotis ve vertebral arter doppler ultrasonografi, servikal bilgisayarlý tomografi veya manyetik rezonans anjiografi tetkikleri incelendi.
Bulgular: Serebellar infarktlarýn damar alanlarýna göre daðýlým sýklýðý deðerlendirildiðinde: en sýk medial Posterior inferior serebellar arter (PÝSA) damar alanýnda infarkt olduðu saptandý. Bunu medial Süperior serebellar arter (SSA) ile lateral PÝSA damar alanlarý takip etmekteydi. Anterior inferior serebellar arter (AÝSA) dýþýnda tüm damarlarda en sýk baþvuru belirtisi bulantý kusmaydý. AÝSA infarktlarýnda ise en sýk belirti
dengesizlikti. Damar alanlarýna göre bulgular deðerlendirildiðinde de tüm damar alanlarýnda en sýk ataksi, dismetri-disdiadokinezi, hipotoni en sýk bulgulardý. En sýk saptanan risk faktörleri hipertansiyon (HT), sigara kullanýmý, diyabetes mellitustu. Etiyolojik faktör olarak: Kardiyoemboli (KE) hastalarýn %22.2’sinde ve vertebrobaziller ateroskleroz (VBA) %61.1’inde saptandý. VBA AÝSA, medial PÝSA, lateral PÝSA alanlarýný içeren infarktlarda, KE ise medial SSA, lateral SSA, lateral PÝSA alanlarýný içeren infarktlarda en sýktý.
Sonuç: Çalýþmamýzda serebellar infarklarýn en sýk medial PÝSA sulama alanýnda olduðunu saptadýk. En sýk belirti bulantý-kusma ve en sýk muayene bulgusu ataksiydi. HT en sýk saptanan risk faktörü ve VBA en sýk etiyolojik faktördü.