ĐẶC ĐIỂM LÂM SÀNG VÀ HÌNH ẢNH CỘNG HƯỞNG TỪ CỦA NHỒI MÁU TIỂU NÃO

Abstract

Objective: To describe the clinical features, magnetic resonance imaging of cerebellar infarction. Subjects and methods: A prospective, descriptive study of 115 patients with cerebellar infarction at the Neurology Department in Bach Mai Hospital from August 2022 to May 2023. Results: The mean age in our series was 64.83 ± 12.18. The male/female ratio was 3.3/1. The risk factors: smoking rate was 36.5%, hypertension rate was 73.9%, diabetes rate was 30.4%, hyperlipidemia rate was 40%, history of stroke or transient ischemic attack rate was 24.3%. Clinical symptoms: vertigo 79.1%, headache 68.7%, dysarthria 64.3%, ataxia 54.8%. The majority of patients had no impairment of consciousness with GCS score 14-15 points 81.7%. Stroke severity at admission mild and moderate majority: 62% NIHSS 0-4 points, 22% NIHSS 5-15 points. Brain MRI: 49.6% of the lesions were localized in the cerebellum, 48.7% focal cerebellar ischemia, 74.8% of patients had cerebellar infarct volume < 25 ml. Affected vascular territories in order of prevalance were PICA (41.8%), SCA (18.3%), and AICA (8.7%). 3D-TOF-MRA: 30.4% vertebrobasilar artery occlusion. Complications: brainstem compression 12.2%, fourth ventricle compression 13.9%, hydrocephalus 4.3%, haemorrhagic transformation 11.3%. Conclusions: Cerebellar infarction mostly presents with nonspecific symptoms like vertigo, nausea, vomiting, and headache, making the diagnosis more difficult. Brain MRI helps determine the diagnosis as well as the affected vascular territories and evaluate other accompanying lesions: vertebrobasilar artery occlusion, complications.