소뇌 소경색의 임상 양상과 발병 기전

Abstract

Background : In the cerebellum, small(<2 cm in diameter)infarcts have recently been reported as having different pathogenic mechanisms from supratentorial small ischemic lesions. However, it is unclear only with simple MRI or conventional CT scan whether they are lacunar infarcts or borderzone infarcts. The purpose of this study was to elucidate the pathophysiological mechanism and the clinical nature of small cerebellar infarcts. Methods : We analyzed consecutive patients admitted to the Hallym stroke center between 1994 and 1999. Among them, we selected ischemic cerebellar stroke and classified them into large territorial, small non-territorial and mixed types according to their infarct sizes. We studied clinical and MRA findings and pathogenic mechanisms in each type of the cerebellar infarcts. Results : Forty-seven patients were selected for the study. Twenty-one cases were classified as large territorial infarcts, 18 patients as small non-territorial cerebellar infarcts. The Mixed form included 8 patients. Patients with large territorial infarcts and those with small cerebellar infarcts had similar risk factors, laboratory findings and clinical features. As for the causative mechanisms, small cerebellar infarcts had similar proportion of large artery disease(66.7% vs. 55.7%) and cardiac embolic source(16.7% vs. 28.6%) when compared to large territorial infarcts. Conclusion : Although the radiologic findings of small cerebellar infarcts resemble supratentorial lacunar lesion, the small cerebellar infarcts have heterogenous etiologies. Diagnostic studies and management of small cerebellar infarcts should be based on the understanding of these observations. Korean Journal of Stroke 2001;3(2): 124~130