Cerebellar Syndrome

Question 1

A unilateral cerebellar lesion causes signs on which side?

Answer 1

Ipsilateral signs

Question 2

What mnemonic gives the symptoms of cerebellar disease, what are these?

Answer 2

DANISH

D - Dysdiadokinesia and Dysmetria (Past-pointing), Drunk
A - Ataxia (limb, trunk)
N - Nystagmus (horizontal - ipsilateral hemisphere)
I - Intention tremor
S - Slurred staccato speech, Scanning dysarthria
H - Hypotonia

Question 3

What are the causes of Cerebellar syndrome?

Answer 3

Friedreich's ataxia, ataxic telangiectasia
Neoplastic: cerebellar haemangioma
Stroke
Alcohol
MS
Hypothyroidism
Drugs: Phenytoin, lead 
Paraneoplastic e.g secondary to lung cancer (mistaken T-cell attack)

Question 4

What is the cerebral perfusion pressure?

Answer 4

The net pressure gradient causing blood to flow to the brain.

Question 5

What happens if CPP rises or falls suddenly?

Answer 5

Sharp rise - rising ICP

Sharp fall - cerebral ischaemia

Question 6

How can cerebral perfusion pressure be calculated?

Answer 6

Mean arterial pressure - intra cranial pressure

MAP - ICP

Question 7

Under what circumstance does CPP need to be carefully monitored?

Answer 7

After trauma

ICP and MAP must be invasively monitored