Stroke occurs when there is insufficient supply of blood from the intracranial arteries to the brain. Blood contains vital food for the brain such as oxygen and glucose. Lack of nutrient supply can damage the cerebellum leading to catastrophic events which may include severe headache, vertigo, uncoordinated movement, vomiting, nausea etc.
In cerebellar stroke, blood supply is restricted to the cerebellum which is at the base of brain. It is caused by blockage in the brain arteries or due to bursting of an aneurysm. Prolonged lack of blood may cause death of neurons giving rise to cerebellar stroke symptoms.
Management of cerebellar stroke is aimed at preventing rapid deterioration and reversing the lost functions as much as possible so that patient can live normal lifestyle.
Causes Of Cerebellar Stroke
Cerebellar stroke occurs when the cerebellar artery supplying the cerebellum area bursts or becomes occluded. It can thus be an ischemic cerebellar stroke or hemorrhagic cerebellar stroke. As a result blood supply in this part of the brain is compromised, leading to death of neurons of cerebellum.
Hemorrhagic cerebellar stroke is more common in fifth to eight decade of life. It is more common in males as compared to females.The most common cause of hemorrhagic stroke is hypertension. Other less common causes include malformation of cerebral arteries, blood dyscracia, aneurysm, brain injury etc.
Occlusion or infarction of cerebellar artery may occur as a result of an emboli originating from the heart or the major blood vessel such as the carotid artery. Patients with occluded artery usually suffer from hypertension and built up of cholesterol in the blood vessel wall. Mostly the posterior inferior cerebellar artery is involved. The blood vessel in the brain may also get mechanically occluded as in case of forceful movement of neck.
Signs And Symptoms Of Cerebellar Stroke
Cerebellar stroke manifests several symptoms such as:
- Severe headache in the back portion of head or skull. At least 35 percent of patients with infarct and occluded artery suffer from it. Majority patients having hemorrhagic cerebellar stroke have severe headache.
- Unsteady gait.
- Nausea and vomiting.
- Decreased level of consciousness which may lead to lethargy.
- Involuntary movement of eyes which may result in reduced vision.
- Slurred speech which is difficult to understand. Patient mumbles rapidly or speaks very slowly.
- Change in quality of voice or hoarseness of voice.
- Tinnitus or abnormal sounds in ear sometimes leading to deafness.
- Double vision.
Treatment For Cerebellar Stroke
Once the cerebellar stroke is diagnosed, the goal of therapy is to avoid further development of infarction or bleeding and if already present, to restrict its progression. The treatment of cerebellar stroke can be divided in three phases. Saving the life of the patient and speed up the recovery, rehabilitating the patient which includes physical, occupational and social rehabilitation. The third phase is steps to prevent its recurrence.
The treating doctor has to first assess whether the stroke is due to occlusion in the artery or a hemorrhagic stroke. Once confirmed, the treatment becomes easy. In its acute stage, maintaining blood pressure, pulse, respiration, is vital.
In case of an embolus or formation of clot in the artery, patient is given blood thinning drugs to melt the clot and allow free flow of blood through the artery. In case of hemorrhagic stroke surgical procedures may be required to remove the hematoma if it is large.
As soon as the patient shows sign of recovery with some volitional movements, active physical therapy will help to strengthen and improve the flexibility of muscles.
80 percent of stroke survivors have high chances of stroke recurrence in first few years. Modifying the risk factors helps in declining the chances of stroke. Prevention strategies are;
- Controlling high blood pressure.
- Stop smoking and alcohol.
- Take proper medications as directed by the physician.
- Change in diet.
- Maintaining optimal weight.
- Controlling high blood cholesterol and diabetes if present.