Cerebellar cortical infarct cavities and vertebral artery disease

Neuroradiology. 2016 Sep;58(9):853-7. doi: 10.1007/s00234-016-1707-9. Epub 2016 May 28.

Abstract

Introduction: Cerebellar cortical infarct cavities are a newly recognised entity associated with atherothromboembolic cerebrovascular disease and worse physical functioning. We aimed to investigate the relationship of cerebellar cortical infarct cavities with symptomatic vertebrobasilar ischaemia and with vascular risk factors.

Methods: We evaluated the MR images of 46 patients with a recent vertebrobasilar TIA or stroke and a symptomatic vertebral artery stenosis ≥50 % from the Vertebral Artery Stenting Trial (VAST) for the presence of cerebellar cortical infarct cavities ≤1.5 cm. At inclusion in VAST, data were obtained on age, sex, history of vertebrobasilar TIA or stroke, and vascular risk factors. Adjusted risk ratios were calculated with Poisson regression analyses for the relation between cerebellar cortical infarct cavities and vascular risk factors.

Results: Sixteen out of 46 (35 %) patients showed cerebellar cortical infarct cavities on the initial MRI, and only one of these 16 patients was known with a previous vertebrobasilar TIA or stroke. In patients with symptomatic vertebrobasilar ischaemia, risk factor profiles of patients with cerebellar cortical infarct cavities were not different from patients without these cavities.

Conclusion: Cerebellar cortical infarct cavities are seen on MRI in as much as one third of patients with recently symptomatic vertebral artery stenosis. Since patients usually have no prior history of vertebrobasilar TIA or stroke, cerebellar cortical infarct cavities should be added to the spectrum of common incidental brain infarcts visible on routine MRI.

Keywords: Cerebellum; Cortical infarct cavity; Incidental brain infarction; Ischaemia; MRI.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Age Distribution
  • Causality
  • Cerebellar Diseases / diagnostic imaging
  • Cerebellar Diseases / epidemiology*
  • Cerebellar Diseases / prevention & control
  • Cerebral Infarction / diagnostic imaging
  • Cerebral Infarction / epidemiology*
  • Cerebral Infarction / prevention & control
  • Comorbidity
  • Female
  • Humans
  • Incidental Findings
  • Magnetic Resonance Angiography / statistics & numerical data*
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Prevalence
  • Risk Factors
  • Sex Distribution
  • Stents / statistics & numerical data
  • Treatment Outcome
  • Vertebrobasilar Insufficiency / diagnostic imaging
  • Vertebrobasilar Insufficiency / epidemiology*
  • Vertebrobasilar Insufficiency / surgery*