Missed diagnosis of cerebellar stroke is not only detrimental to the diagnostic work up of stroke etiology of individual patients but can also lead to serious complications ( 4). Whereas small ischemic lesions in the cerebellum are detectable by magnetic resonance diffusion weighed imaging (DWI), identification may be difficult or impossible on computed tomography (CT) ( 4). Imaging of cerebellar stroke also may be challenging. Dedicated clinical scales such as the MICARS are available ( 3) but not widely used in routine stroke diagnostic and treatment. Symptoms are frequently underestimated or missed by standard clinical stroke scores such as the National Institutes of Health Stroke Scale (NIHSS). Clinical symptoms of cerebellar stroke are manifold and can be subtle so that they are often not recognized at hospital admission ( 2). Patient age at onset of stroke and lesion volume had no significant effect on recovery from cerebellar symptoms as opposed to severity of symptoms at admission and lesion location.Īcute cerebellar stroke is a relatively rare subtype of acute stroke representing approximately 3% of all ischemic and hemorrhagic strokes ( 1, 2). The generalized linear model identified MICARS score at day 1, lesion location, days after admission and the interaction of the last two on the total MICARS score, whereas there was no significant effect of stroke volume or patient age.Ĭonclusions: Isolated cerebellar stroke can present with low NIHSS while more specific scales like the MICARS indicate a severe deficit. The median MICARS decreased from on day 1 with 23–4 at day 90. Results: Median patient age was 54 years, lesion location in most cases was right (87%) and in the PICA territory (11/15). A generalized linear model for repeated measures was employed to analyze the effect of stroke lesion location, volume, days after stroke, patient age, and MICARS score at admission on the total MICARS score. Methods: Fifteen patients with acute isolated cerebellar stroke received a standard stroke MRI on the day of admission and were clinically assessed using the mRS, NIHSS and the modified International Cooperative Ataxia Rating Scale (MICARS) on day 1, 3, 7, 30, and 90. 3Department of Neurology, Charité, University of Medicine Berlin, Berlin, Germanyīackground: The aim of this prospective study was to investigate clinical deficits of patients with isolated cerebellar stroke applying a dedicated clinical score, the modified International Cooperative Ataxia Rating Scale (MICARS) and identifying factors that influence recovery.2Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.1Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.Alina Nickel 1 *, Bastian Cheng 1, Hans Pinnschmidt 2, Emine Arpa 1, Christos Ganos 3, Christian Gerloff 1 and Götz Thomalla 1
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