Investigation of Cerebellar Stroke

Question 1

Signs of a cerebellar stroke?

Answer 1

Past pointing
Dysdiadochokinesis
Acute clumsiness of one hand

Question 2

Useful investigations for cerebellar stroke cause?

Answer 2

ECG - atrial fibrillation
Bloods - FBC (polycythaemia +/- abnormal platelet), raised ESR (vasculitic cause)
Magnetic resonance angiography (MRA) - show obvious site of posterior circulation occlusion

Question 3

Why is a carotid doppler unlikely to be helpful when investigating cerebellar stroke?

Answer 3

Infarct is most likely in posterior circulation territory so likely won’t show anything and waste therapeutic time

Question 4

Best investigation for cerebellar infarct and why?

Answer 4

Magnetic Resonance Angiography (MRA)

• will show any obvious site of posterior circulation occlusion
• if no occlusion seen, it is still helpful in guiding further investigation and management