Background: Space occupying brain edema after cerebellar infarction can lead to life-threatening situation. Prognostic factors for these situations were unclear. In this retrospective analysis, we investigated the patients with cerebellar infarction to identify the prognostic factors.
Methods: We identified 40 patients with severe cerebellar infarction. Clinical features, vital signs, past medical history, mechanism of infarction, vascular territory, the ratio of the lesion volume to the whole cerebellum volume on diffusion-weighted imaging within 24 hours from the onset, if available, and outcome were analyzed. Poor outcome was defined as; 1) undergoing surgical treatment, 2) impaired consciousness level less than Japan Coma Scale-10, 3) death.
Results: 28 patients had good outcome and 12 patients had poor outcome. Clinical features other than vertigo, vital signs, past medical history, mechanism of infarction, and vascular territory of poor outcome group were not significantly different from those of good outcome group although the ratio of the lesion volume to the whole cerebellum volume was significantly different (median, 0.18 vs 0.30; p=0.013). The receiver operating characteristic curve identified the cutoff value of 0.225 (70.0%, sensitivity; 81.8%, specificity). The area under the curve showed 0.82 (95% confidence interval; 0.63-1.0).
Conclusions: The ratio of the lesion volume may affect poor outcome in patients with severe cerebellar infarction.
