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.
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There are 2 main types of stroke: ischemic and hemorrhagic. An ischemic stroke is the most common type of stroke.
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—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.
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:
, amphetamines, or heroin use
- 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 cholesterol
- Low bone mineral density, especially in women
- High blood homocysteine level
Type 2 diabetes
or impaired glucose tolerance
Blood disorders such as
sickle cell disease
Disease of heart valves, such as
Prior stroke or cardiovascular disease, such as
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:
- Certain autoimmune diseases
Migraine with aura
- Having a blood vessel abnormality
- Psychological disorders, such as depression or anxiety
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
- Pregnancy—due to increased risk of blood clots
Symptoms of a cerebellar stroke come on suddenly and may include:
- Uncoordinated movements of the limbs or trunk
- Difficulty walking, including problems with balance
- Abnormal reflexes
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
- Problems with vision, like eyes move rapidly or difficulty controlling eye movement
- Problems with eyes, like small pupils or droopy eyelids
- 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.
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:
Magnetic resonance angiography
- CT angiogram (CTA)
Blood tests can also help identify clotting problems in the blood. The fluid that surrounds your brain and spine may be examined.
Immediate treatment is needed to:
- Dissolve or remove a clot (for ischemic stroke)
- Stop bleeding (for hemorrhagic stroke)
For an ischemic stroke, the doctor may give medications to:
- Dissolve clots and/or prevent new ones from forming
- Thin blood
- Control blood pressure
- Reduce brain swelling
- Treat an irregular heart rate
For a hemorrhagic stroke, the doctor may give medications to:
- Work against any blood-thinning drugs you were taking before the stroke
- Reduce how your brain reacts to bleeding
- Control blood pressure
For an ischemic stroke, the doctor may do surgery to:
- Reroute blood supply around a blocked artery
Remove fatty deposits from a carotid artery—carotid artery endarterectomy
Widen and keep open a carotid artery—atherectomy of noncoronary vessel
- Remove the clot or deliver clot-dissolving medication
A catheter may also be passed through the blood vessels to the blocked area. The catheter can help remove the clot or deliver medication directly to the area.
For a hemorrhagic stroke, the doctor may:
Remove a piece of the skull to relieve pressure on the brain—craniotomy
- Place a clip or a tiny coil in an aneurysm to stop it from bleeding
A rehabilitation program focuses on:
- Physical therapy—to regain as much movement as possible
- Occupational therapy—to assist in everyday tasks and self-care
- Speech therapy—to improve swallowing and speech challenges
Psychological therapy—to improve mood and decrease
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.
. Limit dietary
, talk to your doctor about ways to quit.
- Increase your consumption of fish.
- Drink alcohol only in moderation. This means no more than 1 drink per day for women and 2 drinks per day for men.
- 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.
EBSCO Medical Review Board Rimas Lukas, MD