Cerebellar Stroke: Symptoms, Effects, and Recovery

A cerebellar stroke occurs when there is bleeding or blockage of a blood vessel in part of the brain called the cerebellum, affecting healthy blood flow to the area. This is one of the least common types of stroke, accounting for less than 2% percent of all cases.

Symptoms of cerebellar stroke can be vague. This is so much so that cerebellar stroke symptoms can be easily confused with those of other conditions.

Cerebellar strokes are dangerous and may cause serious complications both because of the cerebellum's location and its involvement in physical movements and cognition.

This article provides an overview of cerebellar strokes, including what symptoms they can cause, why they occur, how they are diagnosed, the impact they can have on your health, and how they are treated.

Cerebellar Stroke Causes

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 any of these blood vessels can cause a cerebellar stroke.

Having certain risk factors can also make it more likely that you'll have a cerebellar stroke. These are the same as for any ischemic stroke in any part of the brain:

• Smoking
• Hypertension (high blood pressure)
• Elevated fat and cholesterol levels
• Heart disease
• Diabetes

Other risk factors for a cerebellar hemorrhagic stroke include:

• Extreme hypertension or a ruptured brain aneurysm
• Neck trauma to the back of the neck can injure the blood vessels that supply the cerebellum, which can cause an ischemic or hemorrhagic stroke

Cerebellar Stroke Symptoms

The cerebellum is small, but because there are several blood vessels that provide nutrient-rich blood to it, a cerebellar stroke typically involves only one section or one of the two sides of this part of the brain.

Given how these hemispheres function, a stroke in the right one would only cause symptoms on the right side of the body; a stroke in the left one would only affect the left side of the body.

Common cerebellar stroke symptoms can be symptoms of several other conditions that vary in seriousness. A cerebellar stroke may not be the first thing that comes to mind when they occur, which can delay the immediate treatment needed for this condition.

While they don't occur in every case, there are also other symptoms that are considered highly indicative of a cerebellar stroke.

Common Symptoms

Common symptoms of cerebellar stroke include:

• Dizziness
• Headaches
• Nausea and vomiting
• Difficulty walking
• Coordination problems
• Double vision
• Tremors
• 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. It's also possible for medical professionals to point to another, less serious condition as the cause early on.

Telltale Symptoms

Knowing the trademark symptoms of a cerebellar stroke and seeking immediate medical attention if they occur can help healthcare providers more accurately and quickly reach a diagnosis.

These symptoms include:

• Jerking of the arms or legs
• Subtle shaking of the body
• A jerking appearance of the eyes when they move from left to right

Whether or not these occur depends on how large the stroke is and exactly where it's located in the cerebellum.

Complications

Some possible complications of cerebellar stroke include:

• Coordination problems, typically on one side of the body
• Trouble walking
• Double vision
• Speech problems
• Tremors
• Jerking movement 

Swelling of the brain is also a possibility. This can lead to compression of the brain within the skull, which can damage 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. This can cause a buildup of fluid in the brain, a condition called hydrocephalus. It often requires long-term intervention such as ventriculoperitoneal shunt placement.

Cerebellar Stroke Diagnosis

If you have symptoms of a cerebellar stroke, a prompt medical diagnosis is very important. However, it can be tricky to diagnose a cerebellar stroke.

A standard brain CT scan usually will not show a cerebellar ischemic stroke because of the location of the cerebellum, which is low in the brain and protected by bone. This makes it difficult to visualize on a standard brain CT.

A brain MRI can look at the cerebellum more clearly, but because an MRI takes longer to do, it is not the safest option for someone who might be having a stroke and is not stable. A brain CT, on the other hand, can quickly show a brain bleed. These factors all contribute to the occasional misdiagnosis of cerebellar stroke.

Cerebellar Stroke Treatment

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.

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 get better slowly over time.

Summary

The symptoms of a cerebellar stroke can be vague. It's not uncommon for a cerebellar stroke to be diagnosed as another condition. Cerebellar strokes are rare but they share symptoms with more common conditions like migraines.

Getting an accurate and timely diagnosis is important if you have a cerebellar stroke. With time and treatment, a person can recover from a cerebellar stroke.