Definition

The cerebellum is located in the lower part of the brain, towards the back. This part of the brain 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 blood, the brain tissue quickly dies. This results in the loss of certain functions. A stroke is a serious condition that needs emergency care.

Cerebellum

GM00010_97870_brainstem.jpg

Copyright © Nucleus Medical Media, Inc.

There are two main types of stroke ischemic and hemorrhagic. An ischemic stroke is the most common type of stroke.

Causes

An ischemic stroke is caused by a blockage of the blood flow, which may be due to:

    
  • A clot from another part of the body like the heart or neck. The clot breaks off and flows through the blood until it becomes trapped in a blood vessel supplying the brain.
  • A clot that forms in an artery that supplies blood to the brain.
  • A tear in an artery supplying blood to the brain. Called an arterial dissection.

    • A hemorrhagic stroke is caused by a burst blood vessel. Blood spills out of the broken blood vessel and pools in the brain. This interupts the flow of blood and causes a build up of pressure on the brain.

    Risk Factors

    Factors that may increase your risk of stroke include:

        
  • Sex: Men are more likely to have strokes than women but women are more likely to die of strokes than men
  • African American, Hispanic or Asian/Pacific Islander descent
  • Age: Risk of stroke increases with age particularly after 55 years of age.
  • Family history of stroke

    • Medical conditions that can increase your risk of stroke include:

        
  • High blood pressure (the number one risk factor for ischemic stroke)
  • High blood homocysteine level
  • Atherosclerosis
  • High cholesterol levels—specifically high-LDL "bad" cholesterol
  • Diabetes mellitus or impaired glucose tolerance
  • Atrial fibrillation
  • Blood disorders such as sickle cell disease and polycythemia
  • Disease of heart valves, such as mitral stenosis
  • Prior stroke or cardiovascular disease, such as heart attack
  • Peripheral artery disease
  • Transient ischemic attack (TIA) —a "warning stroke" with stroke-like symptoms that go away shortly after they appear
  • Conditions that increase your risk of blood clots such as:    
  • Cancer
  • Pregnancy
  • Certain autoimmune diseases
  • Having a blood vessel abnormality

    • Lifestyle factors that can increase your risk of stroke include:

        
  • Drug abuse (heroin, cocaine, amphetamines)
  • Smoking
  • Use of birth control pills, especially if you are over 35 years old and smoke
  • Long-term use of hormone replacement therapy
  • Physical inactivity
  • Alcohol abuse

    • 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 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 for medical help right away. Brain tissue without blood flow dies quickly.

    Diagnosis

    The doctor will do a physical exam and look for muscle weakness, visual and speech problems, and movement difficulty. If possible, you will be asked about your symptoms and medical history. Your doctor may use a CT scan or MRI scan of the brain to confirm a stroke or rule out other conditions.

    Your doctor may also order tests that create detailed images of blood vessels. These test will help see which blood vessels may be creating the problem:

        
  • Magnetic resonance angiography (MRA)—maps blood flow
  • CT angiogram (CTA)—creates detailed images of the blood vessels and their blood flow
  • Doppler ultrasound—evaluates flow of blood in the head and neck

    • Blood tests can also help identify clotting problems in the blood. Your doctor may also examine the fluid that surrounds your brain and spine.

    Treatment

    Immediate treatment is needed to:

        
  • Dissolve or remove a clot (for ischemic stroke)
  • Stop bleeding (for hemorrhagic stroke)

    • Medications

    For an ischemic stroke, the doctor may give medications 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 were taking before the stroke
  • 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 fatty deposits from a carotid artery ( carotid artery endarterectomy )
  • Widen and keep open a carotid artery ( angioplasty and stenting )
  • Remove the clot or deliver clot-dissolving medicine

    • A catheter may also be passed through the blood vessels to the blocked area. The catheter can help remove the clot or deliver medicine directly to the area.

    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

    Many of the risk factors for stroke can be changed. Lifestyle changes that can help reduce your chance of getting a stroke include:

        
  • Exercise regularly.
  • Eat more fruits, vegetables , and whole grains . Limit dietary salt and fat .
  • Stop smoking .
  • Increase your consumption of fish.
  • Drink alcohol only in moderation (1-2 drinks per day).
  • Maintain a healthy weight.
  • Check blood pressure frequently . Follow your doctor's recommendations for keeping it in a safe range.
  • Take aspirin if your doctor says it is safe.
  • Keep chronic medical conditions under control. This includes high cholesterol and diabetes.
  • Talk to your doctor about the use of a statins. These types of drugs may help prevent certain kinds of strokes in some people.
  • Seek medical care if you have symptoms of a stroke, even if symptoms stop.
  • Stop the use of recreational drugs (eg, cocaine, heroin, amphetamines).