Cerebellar stroke is an acute violation of blood supply in the tissues of the cerebellum. A stroke in this area of the brain is caused by blockage of the vessel bed or its rupture with hemorrhage. The latter type is less common than the former. Cerebellar stroke is life threatening. Sometimes it can take years to eliminate its effects. What are the causes of such a terrible disease as a cerebellar stroke, its consequences and prognosis? Let's talk about this in more detail.
Cerebellar stroke: what is it?
Cerebellar stroke often develops in acute circulatory disorders in the tissues of the cerebellum. How favorable the final will be depends on how quickly the patient will be helped. Damage to the cerebellum immediately manifests itself in the form of a sharp deterioration in well-being and developmentcoma. It is likely that cerebellar edema may begin. Accordingly, the brain stem will gradually be compressed.
The cerebellar tonsils are located in the foramen magnum. This type of stroke provokes complete paralysis. If the patient is not operated on in a timely manner, then a fatal outcome is possible.
This disease occurs due to the fact that the vessels that feed the cerebellum are damaged. Such a lesion occurs due to thrombosis (the formation of blood clots inside the blood vessels that prevent the free flow of blood), embolism (blockage of the lumen of the blood vessel), or rupture of the arteries.
Symptoms
Symptoms of the disease appear immediately. Many of them are characterized by impaired blood circulation in the brain.
Symptomatic signs are similar to those that occur with a disease called stem stroke. The cerebellum is affected, the first signs will be:
- breathing hard;
- a sharp rise in temperature;
- no swallowing function;
- consciousness is disturbed;
- dry mouth;
- impaired sensitivity to heat, cold and pain.
The nature of the symptoms of a cerebellar stroke directly depends on the lesion and volume.
Classification
Based on the causes and mechanism of the development of the disease, experts divide cerebellar stroke into several types: ischemic andhemorrhagic. Cerebellar stroke comes in different sizes. So, there are two forms: extensive and isolated.
Isolated cerebellar stroke affects the blood supply to the cerebellar artery in the posterior inferior zone. The symptom is dizziness, and sometimes manifests itself as a complex of vestibular disorders. The patient feels severe pain in the back of the head, complains of nausea. He has impaired coordination, gait and speech.
An isolated stroke can occur in the area of the anterior inferior cerebellar artery. Symptomatic signs are accompanied by impaired coordination of movement, speech, gait, fine motor skills and hearing problems. Hearing is impaired on the right if the right hemisphere of the cerebellum is affected, and vice versa.
When the upper cerebellar artery is affected, coordination of movement suffers as an external symptomatic sign. It is difficult for the patient to maintain balance and perform precise movements. The gait immediately changes, the head is spinning, nausea occurs and there are difficulties in pronouncing words.
If the focus of damage to the nervous tissue is large enough, then internal otitis media will be observed among the above symptoms.
Extensive stroke is accompanied by damage to the right and left hemispheres. This is a serious pathology that can lead to death. Usually this form of stroke is observed in the superior and posterior inferior cerebellar arteries. If the cerebellum is supplied with a strong network of collaterals, then all three of its arteries are closely interconnected. Added to the general symptomsstem and cerebral.
Extensive stroke has pronounced symptoms: headache, nausea, vomiting, impaired coordination of movements, speech and balance. In rare cases, breathing and heart problems may occur. Swallowing functions are impaired as a result of damage to the brain stem.
If the volume of the cerebellar lesion is more than a third, then the course of the disease can cause severe swelling of the necrosis zone. As a result - squeezing the brain stem and death. The probability of death is 80% with conservative therapy. It is an extensive form of stroke that requires immediate neurosurgery.
Ischemic cerebellar stroke
Ischemic type of cerebellar lesion occurs in approximately 75% of all cases. As a result of this form, there is a decrease or complete cessation of blood flow to the tissues of the cerebellum. The result is tissue necrosis. Ischemic stroke of the cerebellum most often occurs in patients who suffer from cardiac pathology. The risk of blockage of blood clots in the cerebellar arteries is increased against the background of recent myocardial infarction. So, intracardiac blood clots with arterial blood flow enter the vessels of the brain, causing blockage.
Thrombosis of the cerebellar arteries is most often associated with atherosclerosis. That is, in the case when fat deposits grow. Plaque rupture is almost impossible to avoid.
Bleeding into the cerebellum causes displacement of tissues and compression of structures due to excess blood. Hematomas usually appear due to high blood pressure (hypertension). Against the background of high pressure, the vesselsburst, and the blood immediately enters the parenchyma of the cerebellum.
Hemorrhagic stroke of the cerebellum occurs due to rupture of blood vessels, less often - there is an increase in their permeability. The prognosis in this case is usually disappointing. Lesions are stronger than with ischemic damage. Poor coordination, dizziness, vomiting are the three main symptoms.
Reasons
In ischemic stroke of the cerebellar part of the brain, there are several causes of development. So, the ischemic appearance is provoked by such factors:
- vasospasm;
- clots;
- arterial hypertension;
- atherosclerosis.
Hemorrhagic stroke is less common. However, it can occur even with the slightest damage to the capillaries. The likelihood of this type of appearance increases against the background of aneurysm and arterial dissection.
Risk factors
Specialists identify the main risk factors that provoke cerebellar stroke. So, external factors include:
- lipid spectrum disorder;
- old age;
- male;
- obesity, physical inactivity, metabolic disorders;
- congenital pathology of the vascular walls;
- pathology of hemostasis;
- cardiovascular disease (heart attack, endocarditis, prosthetic valve).
Cerebellar stroke can be caused by adverse external factors. Separately, diseases of the nervous, cardiac and endocrine systems are distinguished:
- diabetes mellitus;
- thrombosis;
- arterial hypertension;
- atherosclerosis;
- previous heart attack and stroke;
- increased blood clotting;
- exceeded norm of cholesterol and glucose in the blood.
The lifestyle of a person also affects: bad habits, frequent stress, physical and mental exhaustion, inactive lifestyle, sleep disturbance, malnutrition.
Strongly affects the occurrence of this disease and the use of medications. Among them are insulin (if not taken in time for diabetes), hormonal drugs in the treatment of heart and endocrine diseases, as well as contraceptive drugs for women.
In rare cases, age, heredity and unfavorable ecological environment may affect.
Treatment
During the diagnosis of a cerebellar stroke, the patient will need to be urgently hospitalized for resuscitation. Depending on the type and form of stroke, doctors select an individual method of treatment. Perhaps it will include an exclusively medical part, and possibly surgery.
Drug treatment is aimed at relieving the acute phase of a stroke:
- blood thinners (for ischemic cerebellar stroke);
- drugs whose action is aimed at increasing blood clotting (for hemorrhagic stroke);
- antihypertensive drugs to normalize blood pressure;
- anticonvulsants (if you have epileptic seizures andconvulsions);
- sedatives and tranquilizers (if the patient has psycho-emotional overexcitation).
Surgery is indicated in cases where the lesion is large.
In the ischemic form of stroke, surgery is performed in order to increase the lumen of the vessel bed, remove the clot that blocked the blood flow, and also redirect the blood flow through the replacement vessel.
In the case of a hemorrhagic stroke, surgical intervention is performed to remove hematomas, relieve swelling of brain tissues and restore the integrity of the damaged vessel. With a stroke of the cerebellum of the brain, recovery and treatment require immediate medical attention.
Stages of recovery
After surgery, the blood supply to the cerebellum is restored. There is no threat to future life. After a cerebellar stroke, recovery begins with a rehabilitation period. Usually in time it lasts more than 1.5 years. At this time, the patient is intensively and diligently working to restore lost abilities.
Rehabilitation is recommended to take place under the supervision of specialists. There are special courses for recovery in narrowly focused centers. The recovery program includes the following therapeutic areas:
- massage;
- physiotherapy;
- exercise therapy;
- exercises to train speech (on your own or with the help of a speech therapist);
- psychologicalhelp;
- physical activity on simulators to restore coordination of movements;
- use of alternative methods of treatment: acupuncture, manual therapy, hirudotherapy.
The patient needs to be patient and stock up on a positive attitude for recovery.
Experts say that only faith in one's own strength and work on oneself will help regain lost skills.
What could be the consequences
Hemorrhage in the tissue of the cerebellum, blockage of blood vessels that feed this vital organ, threaten with serious complications. Cerebellar stroke consequences can cause such:
- swelling of cerebellar tissues;
- displacement of structures in the cerebellum;
- extensive necrosis of nerve cells;
- development of coma;
- fatal.
Within a month, the manifestation of such complications is possible: pneumonia, heart failure, recurrent stroke.
If the patient survived and suffered an acute phase of cerebellar stroke, then in the future he will face a number of limitations in life functions:
- paralysis of limbs;
- discoordination;
- impaired motor function;
- violation of speech (sometimes its complete absence);
- tremor of the limbs due to increased tone of individual muscle groups.
Many patients, even after recovery, cannot stand on one leg. Difficulties often arise intrying to sit on a chair. There are interruptions in the heart rate, the level of sweating increases.
In order to reduce the manifestation of complications, a long recovery process will be needed. However, it will not be possible to fully restore motor function.
Forecast
Cerebellar stroke prognosis offers, to put it mildly, disappointing. There is no hope for a full recovery. However, it all depends on the degree of damage to the cerebellum.
50% chance of impending death. Many patients survived after this disease, but remained disabled.
The prognosis is dangerous in the first week after a cerebellar stroke. Those who survived a month or more are in a better position - life expectancy and the chance of recovery increase.
Working with a psychologist and a speech therapist will help improve your condition. It is imperative to carry out work that will be aimed at minimizing stress and giving up bad habits. Be sure to help morally close people. Only with a positive attitude and following all the doctor's recommendations can you recover, albeit partially.
If you are at risk of cerebellar stroke, then you need to carefully consider preventive measures:
- do sports;
- adequately load the body physically;
- monitor blood pressure;
- avoid stressful situations;
- periodically check blood cholesterol levels;
- do a brain scan.
Of course, following thesepreventive measures can not help to avoid the disease. However, it will reduce the likelihood of its development.
If possible, get treatment from competent specialists with extensive experience. Rehabilitation is best done in a special center. Experienced and trained staff, as well as appropriate equipment, will help you recover faster after suffering a cerebellar stroke.
When you feel the first signs of the disease, immediately consult a specialist. Prompt diagnosis and treatment is the key to your longevity.
