We examined cerebellar infarction cases treated in our department after approval of the recombinant tissue plasminogen activator (rt-PA), and explored indications for rt-PA administration in cerebellar infarction. In 29 patients diagnosed with acute cerebellar infarction by magnetic resonance imaging findings, we examined chief complaints at the initial visit, time from onset to diagnosis, infarction site, acute-phase drug therapy and outcomes at hospital discharge. Most chief complaints at the initial visit were vertigo or staggering gait. The infarction site was in the posterior inferior cerebellar artery (PICA) territory in 26 patients and in the superior cerebellar artery territory in three. Drug therapies used in the acute phase included free radical scavengers (cerebral protective agents), antiplatelet agents and anticoagulant agents. Six patients were diagnosed within the rt-PA therapeutic time window, but none were given rt-PA. While 26 patients had favorable outcomes at discharge, three had poor outcomes, though cerebellar infarction was not a direct cause of these outcomes. Our findings suggest that rt-PA is not necessary for treating cerebellar infarction in the PICA territory. The use of rt-PA should be considered in cerebellar infarction presenting with obvious neurological symptoms, such as cerebellar ataxia.
