A cerebellar stroke is an acute disturbance in the blood supply to the tissues of the cerebellum. A stroke in this area of the brain is caused by the blockage of the bloodstream of the vessel or its rupture with hemorrhage. The latter type is less common than the first. A cerebellar stroke is dangerous to human life. Sometimes it can take years to eliminate its consequences. What are the causes of the emergence of such a terrible disease as cerebellar cerebral stroke, its consequences and predictions? Let's talk about this in more detail.
Cerebellar stroke: what is it?
A cerebellar stroke often develops in acute circulatory disorders in the tissues of the cerebellum. How favorable the ending 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 the development of coma. It is likely that cerebellar edema may begin. Accordingly, the brain stem will gradually be squeezed.
The tonsils of the cerebellum are located in the large occipital foramen. 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 damage to the vessels that feed the cerebellum. Such a lesion occurs due to thrombosis (the formation of blood bundles inside the blood vessels that impede the free flow of blood), embolism (blocking the lumen of a blood vessel) or rupture of arteries.
Symptoms
Symptoms of the disease appear immediately. Many of them are characterized by circulatory disorders in the brain.
Symptomatic symptoms are similar to those that occur with a disease called stem stroke. The cerebellum is affected, the first signs will be as follows:
- It's difficult to breathe;
- a sharp increase in temperature;
- swallowing function is absent;
- consciousness is disturbed;
- dry mouth
- sensitivity to heat, cold and pain is impaired.
The nature of the symptoms of cerebellar stroke directly depends on the lesion and volume.
Classification
Based on the causes and mechanism of the disease, experts divide into several types of cerebellar stroke: ischemic and hemorrhagic. Stroke of the cerebellum can be of a different scale. So, there are two forms: extensive and isolated.
An isolated cerebellar stroke affects the blood supply to the cerebellar artery in the posterior lower zone. Symptom - 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 of movements, gait and speech.
An isolated stroke may occur in 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 cerebellar hemisphere is affected, and vice versa.
When the upper artery of the cerebellum is damaged, movement coordination suffers as an external symptomatic sign. It is difficult for the patient to maintain balance and perform accurate movements. The gait changes immediately, the head is spinning, nausea occurs and difficulties appear when pronouncing the words.
If the focus of damage to the nerve tissue is large enough, then among the above symptoms, internal otitis media will also be observed.
Extensive stroke is accompanied by damage to the legal and left hemispheres. This is a serious pathology that can lead to death. Typically, this form of stroke is observed in the upper and posterior lower cerebellar arteries. If the cerebellum is equipped with a strong network of collaterals, then all three of its arteries are closely interconnected. Stem and cerebral are added to the general symptoms.
An extensive stroke has a pronounced symptomatology: headache, nausea, vomiting, impaired coordination of movements, speech and balance. In rare cases, breathing and heart problems may occur. Swallowing function 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 - compression of the brain stem and death. The probability of death is 80% with conservative therapy. It is an extensive form of stroke that requires immediate neurosurgical surgery.
Cerebellar ischemic stroke
An ischemic type of cerebellar lesion occurs in approximately 75% of all cases. Due to this form, there is a decrease or complete cessation of blood flow to the tissues of the cerebellum. As a result, tissue necrosis. Cerebellar ischemic stroke is most often found in patients who suffer from cardiac pathology. The risk of blockage of cerebral arterial thrombi is increased against recent myocardial infarction. So, intracardiac thrombi with a flow of arterial blood enter the blood vessels of the brain, causing blockage.
Cerebellar artery thrombosis is most often associated with atherosclerosis. That is, in the case when fat deposits grow. Plaque rupture is virtually impossible to avoid.
Cerebral hemorrhage causes tissue displacement and squeezing of structures due to excess blood. Hematomas usually appear due to high blood pressure (hypertension). Against the background of high pressure, the vessels burst, and the blood immediately enters the cerebellar parenchyma.
Hemorrhagic cerebellar stroke 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. Decreased coordination, dizziness, and vomiting are the three main symptoms.
Causes
With an ischemic form of a cerebellar stroke, several causes of development are distinguished. So, the ischemic species is provoked by such factors:
- vasospasm;
- blood 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 species increasing against the background of aneurysm and dissection of the arteries.
Risk factors
Specialists identify the main risk factors that provoke cerebellar stroke. So, external factors include:
- violation of the lipid spectrum;
- advanced age;
- male;
- obesity, lack of exercise, metabolic disorders;
- congenital pathology of the vascular walls;
- pathology of hemostasis;
- cardiovascular diseases (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;
- thrombosis;
- arterial hypertension;
- atherosclerosis;
- heart attack and stroke;
- increased blood coagulation;
- Exceeded cholesterol and blood glucose.
The lifestyle of a person also affects: bad habits, frequent stresses, physical and moral exhaustion, inactive lifestyle, sleep disturbance, malnutrition.
It strongly affects the appearance of this disease and the administration of medications. Among them, insulin is isolated (if untimely taken for diabetes), hormonal drugs in the treatment of heart and endocrine diseases, as well as contraceptive drugs in women.
In rare cases, age, heredity and adverse environmental conditions can affect.
Treatment
During the diagnosis of a stroke, the cerebellum will need the patient to urgently be hospitalized for resuscitation. Depending on the type and form of the stroke, doctors select an individual treatment technique. Perhaps it will include only the medical part, and possibly surgical intervention.
Drug treatment is aimed at relieving the acute phase of a stroke:
- blood thinners (with ischemic cerebellar stroke);
- drugs whose action is aimed at increasing blood coagulation (with hemorrhagic stroke);
- antihypertensives to normalize blood pressure;
- anticonvulsants (if there are seizures and seizures);
- sedatives and tranquilizers (if the patient has psycho-emotional overexcitation).
Surgery is indicated in cases where the lesion is large.
With an ischemic form of a stroke, the operation is performed in order to increase the lumen of the bloodstream of the vessel, remove the blood clot that blocked the blood flow, and also redirect the blood flow to the replacement vessel.
In the case of a hemorrhagic stroke, surgical intervention is performed to remove hematomas, remove swelling of the brain tissue and restore the integrity of the damaged vessel. With a stroke of the cerebellum of the brain, recovery and treatment require immediate medical attention.
Recovery steps
After surgery, the blood supply to the cerebellum is restored. There is no threat to later 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 on the restoration of lost abilities.
It is recommended to undergo rehabilitation under the supervision of specialists. There are special courses for rehabilitation in narrowly targeted centers. The recovery program includes the following therapeutic areas:
- massage;
- physiotherapy;
- Exercise therapy;
- exercises for training speech (independent or with the help of a speech therapist);
- psychological help;
- physical activity on simulators to restore coordination of movements;
- use of non-traditional methods of treatment: acupuncture, manual therapy, hirudotherapy.
The patient needs to be patient and stock up on a positive attitude towards recovery.
Experts say that only faith in one's own strength and work on oneself will help to regain lost skills.
What could be the consequences
Cerebral hemorrhage in the cerebellum tissue, blockage of the vessels that nourish this vital organ, threaten serious complications. Cerebellar stroke consequences can cause such:
- cerebellar edema;
- displacement of structures in the cerebellum;
- extensive necrosis of nerve cells;
- coma development;
- fatal outcome.
Within a month, the manifestation of such complications is possible: pneumonia, heart failure, repeated 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 vital functions:
- paralysis of the limbs;
- impaired coordination of movements;
- impaired motor function;
- speech impairment (sometimes its complete absence);
- tremor of the extremities due to increased tone of certain muscle groups.
Many patients, even after recovery, cannot stand on one leg. Often there are difficulties when trying to sit on a chair. There are interruptions in the heart rhythm, and the level of sweating rises.
In order to reduce the manifestations of complications, a long recovery process will be required. However, it will not be possible to fully restore motor function.
Forecast
A cerebellar stroke prognosis suggests, to put it mildly, a disappointing one. One does not even have to hope for a full recovery. However, it all depends on the degree of damage to the cerebellum.
The probability of impending death is 50%. Many patients survived this disease, but remained disabled.
A prognosis is dangerous in the first week after a cerebellar stroke. Those who were able to survive a month or more are in a better position — life expectancy and chance of recovery are increasing.
Work with a psychologist and speech therapist will help improve the condition. It is imperative to carry out work that will be aimed at minimizing stress and abandoning addictions. Be sure to help mentally close people. Only with a positive attitude and compliance with all the doctor's recommendations can you recover, although partially.
If you are at risk for cerebellar stroke, then you need to carefully consider preventive measures:
- do sport;
- adequately load the body physically;
- monitor blood pressure;
- avoid stressful situations;
- periodically check the level of cholesterol in the blood;
- do a brain tomography.
Of course, compliance with these preventive measures cannot help to avoid the disease. However, it will reduce the likelihood of its development.
If possible, undergo treatment with competent specialists with extensive experience. Rehabilitation is best done in a special center. Experienced and trained personnel, as well as appropriate equipment, will help to recover faster after a cerebellar stroke.
If you feel the first signs of the disease, immediately contact a specialist. Prompt diagnosis and treatment is the key to your lifespan.