Abstract
We attempted to clarify the clinical features and mechanisms of infarction which is limited to the middle cerebellar peduncle. Over the course of about 9 years, 19 patients with anterior inferior cerebellar artery (AICA) territory infarction diagnosed by magneric resonance imaging (MRI) were admitted to our hospital. Among these 18 patients, MRI demonstrated ischemic lesions limited to the middle cerebellar peduncle in 7 patients (1 bilateral case, 6 unilateral cases; 3 males, 4 females; age range, 52-76 years old; average age, 66.3 years old). We assessed the risk factors, mechanisms, neurological characteristics, angiograms (6 cases), auditory brainstem responses (ABRs; 2 cases), and prognosis. As risk factors, byperlipidemia (6 cases), hypertension (5 cases), a history of cerebrovascular disease (4 cases), diabetes mellitus (3 cases), smoking (2 cases), and heart disease (1 case) were identified. The infarcr was thrombotic in all of the 7 patients. Cerebellar ataxia (gait instability, limb ataxia, and dysarthria) was observed in all of the 7 cases. Vertigo (4 cases) and hearing impairment (1 cases) were also encountered. However, cerebellar ataxia (gait instability, limb ataxia, and dysarthria) only was noted in 3 out of the 7 patients. Lesions of the vertebrobasilar system were detected in 4 out of the 6 patients who underwent cerebral angiography. ABRs were recorded in 2 patients, and abnormal responses were found in both of them. Their prognosis was relatively excellent. All patients were ambulatory at the time of 3 months after onset, althought mild or moderate residual deficits were present. We posturlate that a watershed infarction caused by large-artery occlusive disease resulted in infarctions limited to the middle cerebellar peduncle.
