Atherothrombotic cerebellar infarction - Vascular Lesion-MRI correlation of 31 cases

Background and Purpose-Correlation of MRI findings with atherosclerotic vas cular lesions has rarely been attempted in patients with cerebellar infarct ion. The aim of this study was to correlate the MRI lesions with the vascul ar lesions seen on conventional cerebral angiography in cerebellar infarcti on, Methods-The subjects included 31 patients with cerebellar infarcts who unde rwent both MRI and conventional cerebral angiography. We analyzed the risk factors, clinical findings, imaging study, and angiography results. We atte mpted to correlate MRI lesions with the vascular lesions shown in the angio grams. Results-The vascular lesions seen on angiograms were subdivided into 3 grou ps: large-artery disease (n=22), in situ branch artery disease (n=6), and n o angiographic disease with hypertension (n=3). The proximal segment (V1) l esions of vertebral artery were the most common angiographic features in pa tients with large-artery disease in which stroke mast commonly involved the posterior inferior cerebellar artery (PICA) cerebellum. The V1 lesions wit h coexistent occlusive lesions of the intracranial vertebral and basilar ar teries were correlated with cerebellar infarcts, which had no predilection for certain cerebellar territory. The intracranial occlusive disease withou t V1 lesion was usually correlated with small cerebellar lesions in PICA an d superior cerebellar artery (SCA) cerebellum. The subclavian artery or bra chiocephalic trunk lesion was associated with small cerebellar infarcts. Th e in situ branch artery disease was correlated with the PICA cerebellum les ions, which were territorial or nonterritorial infarct. No angiographic dis ease with hypertension was associated with small-sized cerebellar infarcts within the SCA, anterior inferior cerebellar artery, or SCA cerebellum, Conclusions-Our study indicates that the topographic heterogeneity of cereb ellar infarcts are correlated with diverse angiographic findings. The resul t that large-artery disease, in which nonterritorial infarcts are more comm on than territorial infarcts, is more prevalent than in situ branch artery disease or small-artery disease, suggest that even a small cerebellar infar ct can be a clue to the presence of large-artery disease.