Cerebellar Stroke

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A stroke involving the cerebellum is one of the least common types of stroke, accounting for less than 2% percent of all strokes. However, research has also shown that this type of stroke has twice the mortality rate of more common cerebral stroke. Symptoms of cerebellar strokes are so vague that they can be confused with other illnesses. However, cerebellar strokes are particularly dangerous and may cause serious complications because of the unique location of the cerebellum. If you or a loved one has had a cerebellar stroke, you can find answers to your questions here.

Doctor Examining Brain MRI
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The cerebellum is a part of the brain that controls balance and coordination of the body and coordination of eye movement. The cerebellum is located at the lower back of the brain and it has a right and left side, which are identical in appearance. Each side controls the coordination of the body that is on the same side as the cerebellum.

The cerebellum is small, but because there are several blood vessels that provide nutrient-rich blood to the cerebellum, a cerebellar stroke typically involves only one section or one side of the cerebellum, producing symptoms that affect one side of the body.

The blood vessels that reach the cerebellum are called the superior cerebellar artery, the anterior inferior cerebellar artery, and the posterior inferior cerebellar artery. A blood clot, bleeding or trauma to these blood vessels can cause a cerebellar stroke.

Causes and Risk Factors

A blood clot, bleeding, or trauma can cause a cerebellar stroke. The risk factors for a blood clot causing a cerebellar stroke are the same as the risk factors for any ischemic stroke in any part of the brain. These include smoking, hypertension, elevated fat and cholesterol levels, heart disease, and diabetes. The risk factors for a cerebellar hemorrhagic stroke include extreme hypertension or a ruptured brain aneurysm. And neck trauma to the back of the neck may injure the blood vessels that supply the cerebellum, leading to an ischemic or a hemorrhagic stroke.


A cerebellar stroke most often manifests with dizziness, headaches, nausea, and vomiting. Additionally, people with a cerebellar stroke may have difficulty walking, coordination trouble, double vision, tremors, and trouble speaking.

Nonspecific neurological symptoms such as dizziness and headaches are more common in people who experience a cerebellar stroke than are obvious problems with vision or coordination. Therefore, some people who experience a cerebellar stroke may initially ignore the symptoms, and might not get medical attention until after the symptoms become severe or persistent.

Studies show that even when people with cerebellar strokes receive medical attention, they may be misdiagnosed with migraine headaches or stomach flu because the vomiting and headaches are so much more noticeable than the neurological problems.

There are some trademark stroke signs that may be present when someone has a cerebellar stroke, and this can help your healthcare providers identify the stroke. These include jerking of the arms or legs, subtle shaking of the body, and a jerking appearance of the eyes when they move from left to right. However, not everyone with cerebellar stroke has these signs—it depends on how large the stroke is and its exact location within the cerebellum.


A standard brain CT scan typically does not reveal a cerebellar ischemic stroke due to the location of the cerebellum. It is low in the brain and protected by bone, making it difficult to visualize on a standard brain CT. A brain MRI can better visualize the cerebellum, but because MRI requires a longer time to complete, it is not typically considered safe to have an emergency brain MRI if you are neurologically unstable. Further, a brain CT can quickly show a brain bleed. These factors all contribute to the occasional misdiagnosis of cerebellar stroke.


A cerebellar stroke causes coordination problems of the body, typically on one side. One-sided coordination problems can cause significant impairment in walking. Double vision, speech problems, tremors, and jerking movement may result from a cerebellar stroke. 

Serious short-term complications may include swelling of the brain, which can lead to compression of the brain within the skull, potentially causing further damage to the cerebellum, the brainstem, or other regions of the brain. In the long-term, swelling or excessive bleeding can interfere with the normal flow of cerebrospinal fluid around the brain and spine, causing a buildup of fluid, a condition called hydrocephalus. This condition often requires long-term intervention such as ventriculoperitoneal shunt placement.


Generally, a cerebellar stroke requires a careful evaluation to determine whether there is a brain aneurysm or any unusual blood vessel that could lead to another stroke. Careful management of bleeding and swelling is necessary to prevent hydrocephalus.

You should expect close medical monitoring in the days after experiencing a cerebellar stroke, even if your symptoms do not seem too severe.

Most people who experience a cerebellar stroke improve, but this may take time. Physical therapy is a cornerstone of recovery, particularly when it comes to regaining balance and learning how to walk safely. Over time, tremors and jerking movements may improve. Double vision can be a significant danger when it comes to driving and may cause headaches, but it is likely to improve slowly over time.

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