Munson Healthcare - Cerebellar Stroke - Munson Healthcare

by Stahl RJ

(Stroke, Cerebellar)

Definition

The cerebellum is located in the lower part of the brain, towards the back. It plays a role in body movement, eye movement, and balance.

A cerebellar stroke occurs when the brain’s blood supply to this area is interrupted. Without oxygen and nutrients from blood, the brain tissue quickly dies. This results in the loss of certain functions. A stroke is a serious condition. It requires emergency care.

Cerebellum

Causes

There are two main types of stroke:

Ischemic
Hemorrhagic

An ischemic stroke (more common) is caused by a sudden decrease in blood flow to a region of the brain, which may be due to:

A clot that forms in another part of the body (eg, heart or neck) breaks off and blocks flow in a blood vessel supplying the brain (embolus)
A clot that forms in an artery that supplies blood to the brain (thrombus)
A tear in an artery supplying blood to the brain (arterial dissection)

A hemorrhagic stroke is caused by a burst blood vessel that results in bleeding in the brain.

Risk Factors

Risk factors that you can control or treat include:

Certain conditions, like:
- High blood pressure
- High cholesterol
- Atherosclerosis (narrowing of the arteries due to plaque build-up)
- Atrial fibrillation (abnormal heart rhythm)
- Obesity
- Metabolic syndrome
- Type 2 diabetes
- Alcohol or drug abuse
- Blood circulation problems
Medicines (eg, long-term use of birth control pills )
Lifestyle factors, such as smoking , physical inactivity, diet high in sodium

Risk factors you cannot control include:

History of stroke, heart attack , or other type of cardiovascular disease
History of transient ischemic attack (TIA)—With a TIA (“mini-stroke”), stroke symptoms often resolve within minutes. It may signal a very high risk of having a stroke in the future.
Age: 60 or older
Family members who have had a stroke
Gender: males
Race: Black, Asian, Hispanic
Blood disorder that increases clotting

Symptoms

Symptoms of a cerebellar stroke come on suddenly and may include:

Uncoordinated movements of the limbs or trunk (ataxia)
Difficulty walking, including problems with balance
Abnormal reflexes
Tremors
Vertigo (feeling of spinning or whirling when you are not moving)
Nausea and vomiting
Intense headache
Speech problems (eg, slurred speech) and difficulty swallowing
Problems sensing pain and temperature
Difficulty hearing
Problems with vision (eg, eyes move rapidly, difficulty controlling eye movement)
Problems with eyes (eg, small pupil, droopy eyelid)
Loss of consciousness

If you or someone you know has any of these symptoms, call 911 right away. A stroke needs to be treated as soon as possible. Brain tissue dies quickly.

Diagnosis

The doctor will make a diagnosis as quickly as possible so that you will be able to get the proper treatment. Tests may include:

CT scan —a type of x-ray that uses a computer to make pictures of the brain
CT angiogram—a type of CT scan that evaluates blood vessels in the brain and/or neck
MRI scan —a test that uses magnetic waves to make pictures of the brain
MRA—a type of MRI scan that looks at blood vessels in the brain and/or neck
Heart function tests (eg, electrocardiogram )
Doppler ultrasound —a test that uses sound waves to examine blood vessels
Blood tests
Kidney function tests
Tests to check your ability to swallow

Treatment

Immediate treatment is needed to:

Dissolve a clot (for ischemic stroke)
Stop bleeding (for hemorrhagic stroke)

Medications

For an ischemic stroke, the doctor may give medicines to:

Dissolve clots and/or prevent new ones from forming
Thin blood
Control blood pressure
Reduce brain swelling
Treat an irregular heart rate

For a hemorrhagic stroke, the doctor may give medicines to:

Work against any blood-thinning drugs you may regularly take
Reduce how your brain reacts to bleeding
Control blood pressure
Prevent seizures

Surgery

For an ischemic stroke, the doctor may do surgery to:

Reroute blood supply around a blocked artery
Remove the clot or deliver clot-dissolving medicine
Remove fatty deposits from a carotid artery ( carotid artery endarterectomy )
Widen and keep open a carotid artery ( angioplasty and stenting )

For a hemorrhagic stroke, the doctor may:

Remove a piece of the skull to relieve pressure on the brain ( craniotomy )
Place a clip or a tiny coil in an aneurysm to stop it from bleeding

Rehabilitation

A rehabilitation program focuses on:

Physical therapy—to regain as much movement as possible
Occupational therapy—to assist in everyday tasks and self-care
Speech therapy—to improve swallowing and speech challenges
Psychological therapy—to improve mood and decrease depression

Prevention

To help reduce your chance of having a stroke, take the following steps:

Exercise regularly .
Eat a healthy diet that includes fruit, vegetables, whole grains, and fish.
Maintain a healthy weight.
If you drink alcohol , drink only in moderation (1-2 drinks per day).
If you smoke, quit .
If you have a chronic condition, like high blood pressure or diabetes, get proper treatment.
If you are at risk for having a stroke, talk to your doctor about taking statin medicines .

RESOURCES

American Heart Association
http://www.americanheart.org/

National Stroke Association
http://www.stroke.org/

CANADIAN RESOURCES

Health Canada
http://www.hc-sc.gc.ca/index-eng.php

Heart and Stroke Foundation of Canada
http://ww2.heartandstroke.ca/splash/

References

Am I at risk for a stroke? National Stroke Association website. Available at: http://www.stroke.org/site/PageServer?pagename=risk . Accessed April 15, 2011.

Anatomy of the brain. The University Hospital website. Available at: http://www.theuniversityhospital.com/stroke/anatomy.htm . Accessed April 15, 2011.

Barrett A. Acute cerebellar ataxia. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated March 10, 2011. Accessed April 15, 2011.

Effects of cerebellar stroke. Ohio State University Medical Center website. Available at: http://medicalcenter.osu.edu/PatientEd/Materials/PDFDocs/dis-cond/stroke/EffectsCerebellarStroke.pdf . Accessed April 15, 2011.

Effects of stroke. Magee Rehabilitation website. Available at: http://www.mageerehab.org/effects-of-stroke.php . Accessed April 15, 2011.

Effects of stroke. National Stroke Association website. Available at: http://www.stroke.org/site/PageServer?pagename=EFFECT . Accessed April 15, 2011.

Effects of stroke. Ohio State University Medical Center website. Available at: http://medicalcenter.osu.edu/patientcare/healthcare%5Fservices/stroke/effects/Pages/index.aspx . Accessed April 15, 2011.

Effects of stroke. Rush University Medical Center website. Available at: http://www.rush.edu/rumc/page-1098987413801.html . Accessed April 15, 2011.

Jensen M, St. Louis E. Management of acute cerebellar stroke. Archives of Neurology website. Available at: http://archneur.ama-assn.org/cgi/reprint/62/4/537.pdf . Published April 2005. Accessed April 15, 2011.

Prevention of stroke: recommendations. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/ . Updated April 7, 2011. Accessed April 15, 2011.

Stroke (acute management): treatment overview. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/ . Updated April 7, 2011. Accessed April 15, 2011.

Stroke: causes. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/stroke/DS00150/DSECTION=causes . Updated July 1, 2010. Accessed April 15, 2011.

Stroke: treatments and drugs. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/stroke/DS00150/DSECTION=treatments-and-drugs . Updated July 1, 2010. Accessed April 15, 2011.

Wood D. Stroke. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated March 28, 2011. Accessed April 15, 2011.

Revision Information

Reviewer: Rimas Lukas, MD
Review Date: 06/2012
Update Date: 00/61/2012

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.