J Korean Neurol Assoc > Volume 21(1); 2003 > Article

Journal of the Korean Neurological Association 2003;21(1): 7-13.

급성 양측성 소뇌경색의 임상 양상 및 기전

홍지만 , 신상건 김장성 방오영 주인수 허 균

아주대학교 의과대학 신경과학교실

"Neurological Features and Mechanisms of Acute Bilateral Cerebellar Infarction"

Ji-Man Hong

Department of Neurology, School of Medicine, Ajou University Address for correspondence

Abstract

"Background : Many studies about unilateral cerebellar infarctions (UCI) have been reported to delineate the clinical findings and stroke mechanisms but have not been studied extensively in acute bilateral cerebellar infarctions (BCI). In order to evaluate the neurological features and mechanisms of BCI, we compared those between BCI and UCI. M e t h o d s : Using diffusion-weighted imaging, we divided 103 patients with acute cerebellar infarctions into two groups: BCI and UCI. Clinical features, outcome and their mechanisms were compared between the groups. Results : Among the 103 patients, 45 patients (44%) had BCI and the remaining 58 patients had UCI. The PICA territory was the most frequently involved site in both groups, and 15 patients were non-territorial infarctions. Clinical symptoms and signs were not different between the groups, however, most patients with decreased mentality had BCI (86%) and also had concomitant lesions outside the cerebellum (72%). Patients with BCI showed poorer prognosis than UCI (modified Rankin score, 1.41 and 2.87 respectively). Other factors included the presence of concomitant lesiona outside the cere-bellum, however, mass effect did not affect their prognosis. The main cause of BCI was large artery disease (57%), whereas about half of the patients with UCI (51%) had no demonstrable cause of stroke. Conclusions : Owing to its poorer outcome and its higher frequency of demonstrable causes of stroke, more intensive work-up, such as vascular study, may be warranted in the patients with acute BCI.Key Words : Cerebellar infarction, Magnetic resonance imaging, Prognosis, Mechanism"