Superior cerebellar artery infarcts

Amarenco P and Hauw JJ. Neurology 1990; 40: 1383-1390. Reviewed 33 cases and found only one classic SCA infarct case. Many cases had other associated strokes including PICA, PCA, AICA, top of the basilar syndrome (73%) and even MCA (3 cases). Some cases had tonsillar herniation. 8 patients had coma at onset, 11 had tetraplegia, 9 had cerebellar/vestibular signs. Most cases were embolic either to the distal vertebral artery or the distal basilar artery.



The "classic" syndrome due to occlusion of the artery itself with infarct in the pontine tegmentum includes ipsilateral ataxia and Horner's s, contralateral thermoanalgesia involving face, arm , trunk and leg, fourth nerve palsy, with or without ipsilateral movement disorders. Some cases involved only the medial or lateral branch of the SCA. Delayed coma occurs in SCA only infarcts due to cerebellar swelling. The only "classic" case had associated additional infarcts rostrally.

Amarenco published a companion article on infarcts in the lateral branch of the SCA (Neurology 1991; 41L253-258). Most patients had ipsilateral ataxia, dysarthria, unsteadiness, and axial lateropulsion. One had clumsy hand dysarthria mimicking a lacune. This was usually benign with minimal.no brainstem compression although cardiac emboli were common.