A cerebellar stroke is a rare type of stroke. It affects the cerebellum, an area of the brain responsible for coordinating movement and balance. Ischemic or hemorrhagic events can cause a cerebellar stroke.

A stroke happens when blood flow to a brain area is cut off due to a blockage or because a blood vessel in the brain bursts. As a result, the brain becomes starved of oxygen-rich blood, and parts of it become damaged or die.

Certain factors may increase a person’s risk of experiencing a cerebellar stroke, such as having persistently high blood pressure or advanced age.

After experiencing a cerebellar stroke, rehabilitation may be beneficial to help improve a person’s quality of life and help them regain function.

Another name for this condition is cerebellar stroke syndrome.

This article provides an overview of cerebellar stroke, its symptoms, diagnosis, and treatment.

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Cerebellar stroke is a relatively rare type of stroke, accounting for 1% to 4% of stroke cases.

It happens when a blood vessel in the brain becomes blocked or bursts, interrupting the blood supply to the cerebellum.

The cerebellum is a small, round area at the lower back of the brain. Like the brain itself, it has equal right and left hemispheres, and each side controls the corresponding side of the body.

The role of the cerebellum is to control balance, voluntary movements, eye movements, and more. Therefore, cerebellar strokes cause often cause coordination problems.

Several blood vessels supply the cerebellum, including:

  • the anterior inferior cerebellar artery
  • the posterior inferior cerebellar artery
  • the superior cerebellar artery

A clot or injury to any of these vessels can cause a cerebellar stroke.

Like all strokes, cerebellar strokes are either ischemic or hemorrhagic events.

Ischemic strokes mean there is a blockage to a blood vessel supplying the cerebellum. A clot can appear directly in the blood vessel. Alternatively, the bloodstream can carry it to the vessel from elsewhere in the body.

In contrast, hemorrhagic strokes can occur due to arterial bleeding. This bleeding can damage brain tissue or prevent blood flow, typically by increasing the pressure in the area.

Hemorrhagic strokes can happen spontaneously, especially in people who consistently have high blood pressure.

Several factors can increase a person’s risk of cerebellar stroke. These might include:

Many symptoms of cerebellar stroke that people experience are vague. These nonspecific symptoms can include:

  • nausea
  • vomiting
  • dizziness
  • unsteadiness
  • headache
  • slurred speech
  • coordination issues
  • double vision
  • difficulty with eye movements

Around 3 in 4 people report feelings of vertigo and dizziness. Additionally, more than half report nausea or vomiting.

Doctors may find it difficult to diagnose cerebellar strokes because the symptoms are often nonspecific. However, they use a combination of assessments to help rule out other conditions with similar symptoms.

These assessments can include the following:

  • taking a medical history
  • physical exams
  • neurological exams
  • imaging tests, such as an MRI or CT scan

Imaging tests can show whether there is cerebellar damage or bleeding in the brain. Typically, an MRI is often the first choice, as it can accurately show the cerebellum while leaving the surrounding skull intact.

Strokes require emergency treatment. A person may receive treatment in a specialized stroke unit with a team of specialists.

Treatment can depend on the following:

  • if the stroke was ischemic or hemorrhagic
  • when symptoms began
  • the person’s general health

Ischemic stroke

Treatment for an ischemic stroke may include medications called tissue plasminogen activators (tPA). These drugs dissolve blood clots that may block blood to the cerebellum. Typically, doctors administer tPA within a specific time frame of around 3 to 4.5 hours from the onset of symptoms.

If a person cannot have tPA, anticoagulants or blood thinning medications are suitable alternatives.

A person may also need a surgical procedure to open up blocked arteries and restore blood flow to the brain.

Hemorrhagic stroke

If the stroke is hemorrhagic, doctors may administer blood pressure medication to reduce the stress on blood vessels in the brain. A person will stop any anticoagulant or blood-thinning medications they were taking. A doctor may also give vitamin K to help stop any bleeding.

Doctors may also administer fresh frozen plasma or other medications to reverse the coagulopathy. Coagulopathy refers to a condition that can result in excessive clotting or bleeding.

Individuals may also require surgery to block off the aneurysm from the blood vessels in the brain or to seal it.

If a person has issues with movement and coordination after experiencing a cerebellar stroke, they will likely require rehabilitation.

Rehabilitation programs may consist of the following:

  • Physical therapy: This helps a person regain strength, movement, and coordination. It typically involves exercises and activities that someone performs under the guidance of a physical therapist.
  • Occupational therapy: This therapy teaches someone new ways of performing daily tasks, such as bathing, dressing, and eating. It may also involve the use of adaptive equipment, where necessary.
  • Speech therapy: This therapy helps a person relearn how to speak clearly and swallow properly.

It can take weeks, months, or years to recover from a stroke, and some people may have long-term disabilities following one. However, rehabilitation aims to help a person regain as much independence as possible.

Without emergency care in the event of a stroke, a person may experience serious and potentially life threatening complications.

A condition called cerebral edema can develop — this refers to a buildup of fluid in the brain. Cerebral edema can cause an increase in pressure inside the skull and lead to permanent brain damage, coma, and death.

Timely diagnosis and treatment are beneficial to reducing complications. The main post-stroke complication can be a loss of independence or the ability to perform everyday tasks.

Doctors also associate cerebellar stroke with complications of staying in the hospital. These can include:

The outlook following a cerebellar stroke is similar to that of other types of stroke. Large ischemic strokes tend to have a more negative outlook.

Due to earlier recognition and treatment, the illnesses and conditions relating to cerebellar stroke have declined. People now have a better outlook and improved chance of recovery.

A cerebellar stroke is a type of stroke that occurs in the cerebellum, a part of the brain responsible for coordination and balance. Cerebellar strokes can happen when there is a blockage in the blood supply to the cerebellum due to a blood clot or injury to a blood vessel.

Symptoms of cerebellar stroke are typically vague. However, they might include sudden dizziness or vertigo, loss of coordination, difficulty walking, and slurred speech.

Cerebellar strokes are a medical emergency and require immediate treatment. Recovery is possible, but a person may experience long-term disabilities such as difficulty with movement and coordination. However, with early diagnosis and treatment, the outlook is positive.