A cerebellar stroke involves ischemia or hemorrhage of the cerebellum. Symptoms are typically acute in onset and include ataxia (imbalance, coordination problems), vertigo, dysarthria, nausea, vomiting, dizziness, and headache. There may be a decreased level of consciousness, abnormal breathing, and brain stem signs as well. There are several named syndromes characterized by location of the stroke and resulting symptoms. Prognosis depends on the location and size of the stroke as well as timely evaluation and treatment.

• Ischemic cerebellar strokes are predominantly either thrombotic or embolic. Thrombotic strokes are often caused by atherosclerosis, while embolic strokes are commonly cardiogenic (atrial fibrillation), septic, or due to coagulopathy.
• Hemorrhagic strokes can be intraparenchymal, due to hypertension, or secondary to subdural or subarachnoid hemorrhage.

Cerebellar stroke carries a higher mortality than many other forms of stroke due to the cerebellum's proximity to the brain stem, which may share vascular territory or be compressed by cerebellar edema, potentially leading to coma and death.

Risk factors for cerebellar strokes are the same as for other cerebrovascular pathologies: hypertension, hyperlipidemia, diabetes, cardioembolic risks such as atrial fibrillation, and tobacco abuse are chief among them. Cerebellar hemorrhages can also be caused by a rupture of vascular malformations; hereditary hemorrhagic telangiectasia (HHT) is a particular risk factor. Rupture of vascular malformations is a more likely cause in children. Other risk factors for cerebellar hemorrhages include sympathomimetic abuse such as cocaine use. Increased urinary sodium is associated with increased risk.

Related topic: drug-induced stroke