Address of Corresponding Author

Cerebrovasc Dis 2005;19:283-290 (DOI: 10.1159/000084496)

  Key Words

• Stroke
• Superior cerebellar artery
• Infarction
• Magnetic resonance imaging

  Abstract

Background and Purpose: Infarcts in the territory of superior cerebellar artery (SCA) are uncommon. The clinical, and etiological mechanisms of different infarct patterns of SCA are not well known. Diffusion-weighted imaging (DWI) is superior to conventional magnetic resonance imaging for detecting acute small and multiple ischemic lesions. Methods: We studied 60 patients with lesions involving SCA territory proved by DWI, which have been selected from 3,800 patients with first ischemic stroke consecutively admitted to our stroke unit over a period of 5 years. Results: There are 7 distinctive SCA lesion patterns: (1) a lesion was found in the medial (m) branch territory of SCA (mSCA) in 14 patients; (2) a lesion in the lateral (l) branch territory of SCA (lSCA) was seen in 9 patients; (3) a coexisting lesion involving mSCA and lSCA was found in 9 patients; (4) a lesion in cortical borderzones between SCA and m/l branches of the posterior inferior cerebellar artery (PICA) was observed in 6 patients; (5) a lesion in deep borderzones between lSCA and mSCA, and lPICA and mPICA was present in 8 patients; (6) a lesion involving the medial rostral cerebellum between the right and left SCA was found in 4 patients; (7) multiple lesions involving SCA and other vertebrobasilar artery territories were present in 10 patients. The main cause was possible artery-to-artery embolism from atherosclerotic vertebrobasilar arteries to distal branches of SCA in 20 patients (33%). Fourteen patients had a source of cardioembolism (23%), and 6 patients (8%) had concomitant atherosclerotic vertebrobasilar artery disease and a source of cardioembolism. Conclusions: An acute ischemic lesion in the SCA territory is mainly multiple. The lSCA territory was the most involved area. Small territorial infarcts were frequently associated with large territorial SCA infarcts. Borderzone SCA infarcts occurred in one third of the patients with transient benign symptoms. Mass effects are unusual despite the large amount of SCA involvement. Our results supported the fact that embolism is the predominant stroke mechanism in the SCA territory infarction.

Copyright © 2005 S. Karger AG, Basel

  Author Contacts

Prof. Emre Kumral, MD
Stroke Unit, Department of Neurology, Faculty of Medicine
Ege University, Bornova
TR-35100 Izmir (Turkey)
Tel. +90 532 2165213, Fax +90 232 4634626, E-Mail ekumral@med.ege.edu.tr

  Article Information

Received: July 1, 2004
Accepted: November 1, 2004
Published online: March 17, 2005
Number of Print Pages : 8
Number of Figures : 2, Number of Tables : 2, Number of References : 30