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Misdiagnosis of Cerebellar Infarctions

  • Navdeep Sangha (a1), Karen C. Albright (a2) (a3) (a4), Hui Peng (a5), Farhaan Vahidy, Amelia Boehme (a2), Zhongxue Chen (a5) and Sean I. Savitz (a5)...

This retrospective study addresses for the first time the differences in clinical features and outcomes between those individuals with a cerebellar infarct who were correctly diagnosed on initial presentation compared to those who experienced delayed diagnosis.


A retrospective review was conducted of our stroke registry from 09/2003 to 02/2011. Forty seven patients had an isolated cerebellar infarction confirmed by MRI. Misdiagnosis was defined as the diagnosis given by the first physician.


Among 47 patients identified, 59.6% had delayed diagnosis. Five patients in the correct diagnosis group received intravenous tissue plasminogen activator, compared to none in the delayed diagnosis group. Complaints of weakness were protective from delayed diagnosis (OR 0.087, 95% CI 0.019-0.393, p=0.001).


Patients with an isolated cerebellar infarction need to be considered when patients present with acute non-specific symptoms. Critical components of the neurological examination are omitted which are imperative to diagnose cerebellar infarcts. A thorough neurological examination may increase clinical suspicion of an ischemic stroke.


Cette étude rétrospective aborde pour la première fois les différences entre les manifestations cliniques et l’issue clinique chez les individus atteints d’un infarctus cérébelleux lorsqu’un diagnostic exact a été posé au moment de la consultation initiale par rapport à ceux chez qui le diagnostic a été plus tardif.


Nous avons effectué une revue rétrospective de notre registre de patients atteints d’un accident vasculaire cérébral entre septembre 2003 et février 2011. Quarante-sept patients avaient présenté un infarctus cérébelleux isolé, confirmé par IRM. Le diagnostic posé par le premier médecin qui a examiné le patient a été déterminé comme étant exact ou erroné.


Le diagnostic a été tardif chez 59,6% des 47 patients identifiés. Cinq patients dans le groupe chez qui un diagnostic exact avait été posé initialement ont reçu de l’activateur du plasminogène tissulaire et aucun n’en a reçu dans le groupe de patients chez qui le diagnostic a été tardif. Le fait de se plaindre de faiblesse protégeait d’un diagnostic tardif (RC 0,087; IC à 95% 0,019 à 0,393; p=0,001).


Quand des patients consultent pour des symptômes aigus non spécifiques, un diagnostic d’infarctus cérébelleux isolé doit être envisagé. Des éléments essentiels de l’examen neurologique, qui sont indispensables au diagnostic de l’infarctus cérébelleux, sont omis. Un examen neurologique minutieux peut révéler un tableau clinique qui éveille des soupçons quant à la présence d’un accident vasculaire ischémique chez le patient.

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Corresponding author
Correspondence to: Navdeep Sangha, Department of Neurology, Kaiser Permanente, Los Angeles Medical Center, 1505 N. Edgemont Street, Los Angeles, CA, USA 90027, Email:
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Canadian Journal of Neurological Sciences
  • ISSN: 0317-1671
  • EISSN: 2057-0155
  • URL: /core/journals/canadian-journal-of-neurological-sciences
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