Infarkt im Versorgungsgebiet der Arteria cerebelli superior

Infarkt
Versorgungsgebiet A. cerebelli superior rechts in der Computertomografie: Links axial, rechts koronar und sagittal.
Wikipedia • CC BY-SA 4.0
Middle
cerebral artery (MCA) infarct • Cerebral vascular territories (illustration) - Ganzer Fall bei Radiopaedia
Gaillard, F. Cerebral vascular territories (illustration). Case study, Radiopaedia.org. (accessed on 21 Oct 2022) https://doi.org/10.53347/rID-10814 • CC by-nc-sa 3.0 (modified)
Superior
cerebellar artery infarct • Acute superior cerebellar artery territory infarct - Ganzer Fall bei Radiopaedia
Botz B, Acute superior cerebellar artery territory infarct. Case study, Radiopaedia.org (Accessed on 15 Jun 2024) https://doi.org/10.53347/rID-84104 • CC by-nc-sa 3.0 (modified)
Radiopaedia • CC-by-nc-sa 3.0 • de

Superior cerebellar artery infarcts affect the superior cerebellar hemispheres, cerebellar vermis, and parts of the midbrain. The superior cerebellar artery is the most constantly identified vessel arising from the basilar artery with its origin just below the posterior cerebral artery in the distal segment.

Epidemiology

Cerebellar infarcts comprise ~2% of all acute brain infarcts. Up to half of these involve the region of the superior cerebellar artery .

Clinical presentation

Cerebellar infarction often presents with non-specific symptoms such as nausea/vomiting, headache, and dizziness making initial diagnosis challenging. Superior cerebellar artery infarction can present in two distinct patterns depending on the site of occlusion :

  • occlusion at the origin of the artery produces the classic presentation of ipsilateral cerebellar (ataxia, dysarthria, nystagmus) and brainstem (Horner’s syndrome) signs associated with a contralateral dissociated sensory impairment. Interestingly this was described initially by Mills over 100 years ago .
  • peripheral occlusion presents with solely ipsilateral cerebellar signs.

    • Pseudotumoral cerebellar infarction, which can be seen in posterior inferior cerebellar artery infarction, has not been described for superior cerebellar artery infarcts.

    Pathology

    Important causes of cerebellar infarction include atherosclerosis, cardiogenic emboli, and vertebral/basilar artery dissections . Proximal occlusions of the superior cerebellar arteries are often due to dissection or thrombosis, with peripheral occlusion typically due to embolization .

    Radiographic features

    The imaging features are those of ischemic stroke in the vascular territory of the superior cerebellar artery: superior vermis, superior surface of the cerebellar hemispheres, much of the cerebellar white matter, and regions of the midbrain.

    Siehe auch:
    Assoziationen und Differentialdiagnosen zu Infarkt im Versorgungsgebiet der Arteria cerebelli superior:
    Kleinhirninfarkt
     
    Wikipedia • CC BY 2.0