CEREBELLAR INFARCTS IN THE NEW-ENGLAND MEDICAL-CENTER POSTERIOR CIRCULATION STROKE REGISTRY

We report the clinical findings and stroke mechanisms of 63 patients w ith cerebellar infarcts. We divided the intracranial vertebrobasilar c irculation into the proximal territory (P), fed by the intracranial ve rtebral arteries and their branches; the middle territory (M), fed by the proximal and middle basilar artery and its branches; and the dista l territory (D), fed by the rostral basilar artery and its branches. C erebellar infarcts were classified by vascular territories P, M, D, P& D, and middle-plus (P&M, M&D, and P&M&D). Patients with P infarcts (11 patients) frequently had vertigo, gait instability, limb ataxia, and headache, whereas patients with D infarcts (15 patients) most often ha d limb ataxia, gait instability, and dysarthria. Patients with P&D inf arcts (17 patients) had signs and symptoms of both groups combined. In farcts in which the middle territory was involved, either alone (three patients) or combined with other territories (17 patients) were domin ated by brainstem signs and symptoms. The predominant stroke mechanism s in the P, D, and P&D groups were embolic due to intra-arterial or ca rdiac embolism. When the M territory was involved, either alone or wit h P, D, or P&D territories, stroke mechanisms were more varied, and th ere was often large-artery occlusion with hemodynamic ischemia.