Small obliquely oriented cortical cerebellar infarctions are associated with cardioembolic stroke

• Published in: BMC neurology 2019-05, Vol.19 (1), p.100-100, Article 100
• Main Authors: Ter Schiphorst, Adrien, Tatu, Lavinia, Thijs, Vincent, Demattei, Christophe, Thouvenot, Eric, Renard, Dimitri
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Arteriosclerosis; Atherosclerosis; Atrial fibrillation; Atrial Fibrillation - complications; Boundaries; Brain; Brain infarction; Brain Infarction - classification; Brain Infarction - etiology; Brain Infarction - pathology; Cardiac arrhythmia; Cardioembolic; Cardiovascular diseases; Cerebellar; Cerebellar Diseases - classification; Cerebellar Diseases - etiology; Cerebellar Diseases - pathology; Cerebellum; Cerebral infarction; Classification; Colonies & territories; Complications and side effects; Cortex; Cortical; Diagnostic imaging; Embolism; Embolisms; Female; Fibrillation; Humans; Infarction; Intracranial Embolism - classification; Intracranial Embolism - etiology; Intracranial Embolism - pathology; Life Sciences; Magnetic resonance imaging; Male; Medical imaging; Middle Aged; Neurons and Cognition; Obliquely; Occlusion; Patients; Retrospective Studies; Risk Factors; Stenosis; Stroke; Stroke - classification; Stroke - etiology; Stroke - pathology; Stroke patients; Topography; Ultrasonic imaging
• ISSN: 1471-2377; 1471-2377
• DOI: 10.1186/s12883-019-1328-0

A revised classification of cerebellar infarctions (CI) may uncover unrecognized associations with etiologic stroke subtypes. We hypothesized that obliquely oriented small cortical cerebellar infarction (SCCI) representing end zone infarctions on MRI would be associated with cardiac embolism. We retrospectively analyzed consecutive stroke patients recruited between January-December 2016 in our center. Analyzed baseline characteristics: sex, age, cardiovascular risk factors, history of stroke or atrial fibrillation (AF). TOAST classification was used for determining stroke subtype. Acute infarction location (anterior/posterior/mixed anterior-posterior circulation), acute uni- or multiterritorial infarction, and acute or chronic CI/SCCI/non-SCCI were assessed by MRI, and vertebrobasilar stenosis/occlusion by vessel imaging. Pre-specified analysis was also performed in patients without known high cardioembolic risk (known AF history or acute multiterritorial infarction). We included 452 patients (CI in 154, isolated SCCI in 55, isolated non-SCCI in 50, and mixed SCCI/non-SCCI in 49). Both SCCI and non-SCCI were associated with AF history (SCCI, p = 0.021; non-SCCI, p = 0.004), additional acute posterior circulation infarction (p