Clinical problems in the initial diagnosis of cerebellar infarction

Abstract

Background and Purpose: On occasion, the diagnosis of cerebellar infarction is initially missed. We analyzed the clinical features of cerebellar infarction to clarify factors contributing to the misdiagnosis of cerebellar infarction.
Methods: Twenty two (4.3%) of 514 stroke patients were diagnosed with cerebellar infarction at Asahikawa Medical College between 2006 and 2008. We examined the clinical features of these patients retrospectively.
Results: Eight patients (36.4%) presented with no more than one typical cerebellar symptom. Although three patients came to the emergency room of our hospital within three hours of onset, they were not initially diagnosed with stroke but were admitted to a non-neurology ward. All three patients complained mainly of vertigo and did not present with either dysarthria or gait disturbance. Five patients were not initially diagnosed with cerebellar infarction due to the absence of any cerebellar sign.
Conclusion: We emphasize that clinicians should consider the possibility of cerebellar infarction whenever patients complain of vertigo or vomiting only. We recommend that the stroke team be involved in the diagnosis of patients with vertigo or vomiting.