Definition

The cerebellum is located in the lower part of the brain, towards the back. This part of the brain plays a role in body movement, eye movement, and balance.

A cerebellar stroke occurs when the brain’s blood supply to this area is interrupted. Without blood, the brain tissue quickly dies. This results in the loss of certain functions.

There are two main types of stroke ischemic and hemorrhagic. An ischemic stroke is the most common type of stroke.

Causes

An ischemic stroke is caused by a blockage of the blood flow, which may be due to:

• A clot from another part of the body like the heart or neck. The clot breaks off and flows through the blood until it becomes trapped in a blood vessel supplying the brain.
• A clot that forms in an artery that supplies blood to the brain.
• A tear in an artery supplying blood to the brain. This is called an arterial dissection.

A hemorrhagic stroke is caused by a burst blood vessel. Blood spills out of the broken blood vessel and pools in the brain. This interrupts the flow of blood and causes a build up of pressure on the brain.

Risk Factors

Certain factors increase your risk of stroke but can not be changed, such as:

• Race—People of African American, Hispanic, or Asian/Pacific Islander descent are at increased risk.
• Age: Older than 55 years of age
• Family history of stroke

Other factors that may increase your risk can be changed such as:

• Drug abuse from cocaine, amphetamines, or heroin use
• Smoking
• Physical inactivity

Certain medical condition that can increase your risk of stroke. Management or prevention of these conditions can significantly decrease your risk. Medical conditions include:

• High blood pressure
• High cholesterol levels —specifically high-LDL (bad) cholesterol
• Low bone mineral density, especially in women
• Obesity and metabolic syndrome
• Sleep apnea
• High blood homocysteine level
• Atherosclerosis
• Diabetes mellitus or impaired glucose tolerance
• Atrial fibrillation
• Blood disorders such as sickle cell disease and polycythemia
• Vascular dementia
• Disease of heart valves, such as mitral stenosis
• Prior stroke or cardiovascular disease, such as heart attack
• Peripheral artery disease
• Transient ischemic attack (TIA) —a warning stroke with stroke-like symptoms that go away shortly after they appear
• Conditions that increase your risk of blood clots such as:
  • Cancer
  • Certain autoimmune diseases
• Migraine with aura
• Having a blood vessel abnormality

Risk factors specific to women include:

• Previous pre-eclampsia
• Use of birth control pills, especially if you are over 35 years old and smoke
• Long-term use of hormone replacement therapy
• Menopause
• Pregnancy—due to increased risk of blood clots

Symptoms

Symptoms of a cerebellar stroke come on suddenly and may include:

• Uncoordinated movements of the limbs or trunk (ataxia)
• Difficulty walking, including problems with balance
• Abnormal reflexes
• Tremors
• Vertigo—a feeling of spinning or whirling when you are not moving
• Nausea and vomiting
• Intense headache
• Speech problems and difficulty swallowing
• Problems sensing pain and temperature
• Difficulty hearing
• Problems with vision (eg, eyes move rapidly, difficulty controlling eye movement)
• Problems with eyes (eg, small pupil, droopy eyelid)
• Loss of consciousness

If you or someone you know has any of these symptoms, call for emergency medical services right away. Brain tissue without blood flow dies quickly. Early care can decrease damage.

Diagnosis

A physical exam will be done to look for muscle weakness, visual and speech problems, and movement difficulty. If possible, you will be asked about your symptoms and medical history.

Images may be taken of your bodily structures. This can be done with:

• CT scan
• MRI scan
• Magnetic resonance angiography (MRA)
• CT angiogram (CTA)
• Doppler ultrasound

Blood tests can also help identify clotting problems in the blood. The fluid that surrounds your brain and spine may be examined.

Treatment

Immediate treatment is needed to:

• Dissolve or remove a clot (for ischemic stroke)
• Stop bleeding (for hemorrhagic stroke)

Prevention

Many of the risk factors for stroke can be changed. Lifestyle changes that can help reduce your chance of getting a stroke include:

• Exercise regularly.
• Eat more fruits, vegetables, and whole grains. Limit dietary salt and fat.
• If you smoke, talk to your doctor about ways to quit.
• Increase your consumption of fish.
• Drink alcohol only in moderation. This means 1-2 drinks per day.
• Maintain a healthy weight.
• Check your blood pressure frequently. Follow your doctor’s recommendations for keeping it in a safe range.
• Take aspirin if your doctor says it is safe.
• Keep chronic medical conditions under control. This includes high cholesterol and diabetes.
• Talk to your doctor about the use of statins. These types of drugs may help prevent certain kinds of strokes in some people.
• Seek medical care if you have symptoms of a stroke, even if symptoms stop.
• If you use drugs, talk to your doctor about rehabilitation programs.

National Stroke Association http://www.stroke.org

Heart and Stroke Foundation http://www.heartandstroke.com

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http://www.stroke.org/understand-stroke/what-stroke/hemorrhagic-stroke
Accessed November 18, 2014.

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http://www.strokeassociation.org/STROKEORG/AboutStroke/TypesofStroke/HemorrhagicBleeds/Hemorrhagic-Strokes-Bleeds_UCM_310940_Article.jsp
Updated September 16, 2014. Accessed November 18, 2014.

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http://www.ebscohost.com/dynamed
Updated May 6, 2014. Accessed November 18, 2014.

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Published April 2005. Accessed November 18, 2014.

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http://www.ebscohost.com/dynamed
Updated September 30, 2014. Accessed November 18, 2014.

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http://www.ebscohost.com/dynamed
Updated October 14, 2014. Accessed November 18, 2014.

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http://www.stroke.org/site/PageServer?pagename=SYMP
Accessed November 18, 2014.

Stroke (acute management). EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated October 17, 2014. Accessed November 18, 2014.

Subarachnoid hemorrhage. EBSCO DynaMed website. Available at:
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Updated July 28, 2014. Accessed November 18, 2014.

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