Observation And Analysis Of Clinical And Imaging Features In Patients With Acute Small Cerebellar Infarctions

Objective:The etiology of small cerebellar infarction(SCBI)is still controversial.We intended to investigate the possible causes of SCBI by analyzing the risk factors,clinical and imaging features of patients with SCBI,aiming at providing some data for secondary prevention of stroke.Method:We enrolled consecutive patients with acute cerebellar infarction who admitted to the cerebrovascular disease center of Liaoning provincial people's hospital from October 2017 to April 2019 were collected.The patient's demographic characteristics and vascular risk factors were recorded,admission blood pressure was measured,admission e-NIHSS score was evaluated.The relevant blood test,head magnetic resonance imaging,intracranial vascular ultrasound,cardiac ultrasound and electrocardiogram were performed.Posterior circulation infarction,old lacunar infarction,leukoaraiosis,intracranial and extracranial vascular stenosis were evaluated.Cerebellar infarction was divided into SCBI and large cerebellar infarcts(LCBI)according to the largest diameter of the infarction on diffusion-weighted imaging of magnetic resonance.And cerebellar infarction was also divided into isolated and mixed cerebellar infarction according to the existence of infarctions outside of cerebellum.Results: We enrolled 144 patients of cerebellar infarction.Among them 84 patients had SCBI and 60 patients had LCBI.74 patients had isolated cerebellar infarction and 70 patients had mixed cerebellar infarction.1.In the enrolled 144 patients,80.6%(116/144)of them had e-NIHSS score ?5 and 67.4%(97/144)of them had e-NIHSS score ?3.Compared with the patients of LCBI,the patients of SCBI had lower level of homocysteine(15.80?mol/L vs 18.63?mol/L,P=0.020)and lower e-NIHSS score(1.00 vs 3.00,P=0.003).Multivariate logistic regression analysis showed that e-NIHSS score(OR=0.94,95%CI =0.88 ? 1.00,P=0.034)of SCBI patients was lower than that of LCBI patients.2.In the enrolled 74 patients of isolated cerebellar infarction,91.9%(68/74)of them had e-NIHSS score ?5 and 82.4%(61/74)of them had e-NIHSS score of ?3.Compared with the patients of isolated LCBI,the proportion of male was lower(51.2% vs 77.4%,P=0.019),the level of high density lipoprotein cholesterol(1.04 mmol/L vs 1.21mmol/L,P=0.047)and homocysteine(15.47 ?mol/L vs 18.63 ?mol/L,P=0.015)was lower,and the rate of old lacunar infarction of grade 2(32.6% vs 61.3%,P=0.044)was lower in patients of isolated SCBI.Multivariate logistic regression analysis showed that the rate of atrial fibrillation was lower in patients of isolated SCBI(OR=0.89,95%CI = 0.02?1.00,P=0.048)in comparison with the patients of isolated LCBI.3.There were 43 patients with isolated SCBI,93.0%(40/43)of them had e-NIHSS score ?5,and 83.7%(36/43)of them had e-NIHSS score ?3.Compared with mixed SCBI patients,the proportion of male with isolated SCBI(51.2% vs 78.0%,P=0.009)was lower,the proportion of coronary heart disease(7.0% vs 22.0%,P=0.048)and stroke(18.6% vs 41.5%,P=0.020)were lower,the level of homocysteine(15.47?mol/L vs 17.09 ?mol/L,P=0.028)and the e-NIHSS score(1.00 vs 3.00,P=0.002)were lower.Multivariate logistic regression analysis showed that in patients with isolated SCBI,the proportion of males(OR=0.17,95%CI = 0.04?0.68,P=0.012)was lower,the baseline diastolic blood pressure(OR=0.60,95%CI = 0.37? 0.98,P=0.042)and the e-NIHSS score were lower(OR=0.80,95%CI= 0.65? 0.99,P=0.037).Conclusion:The patients of SCBI were mainly of mild stroke.The risk factors of atherosclerosis and the rate of vertebral artery/basilar artery stenosis were similar to those of the patients of LCBI.