Patients with cerebellar ischemic stroke may be misdiagnosed and may exhibit a delayed time to acute stroke treatment compared with patients with anterior circulation ischemic stroke. The posterior circulation Alberta stroke program early computed tomography score (pc-ASPECT) score has been used to evaluate hyperacute stroke, much as the ASPECT in anterior circulation stroke recently. Our main objective was to evaluate the associations of the clinical and etiological characteristics of ischemic cerebellar infarction patients on admission with their pc-ASPECT scores, as well as the correlations of the pc-ASPECT score with morbidity and mortality rates.
We include 114 patients with cerebellar infarction who underwent 1 year of follow-up into the study.
Patients with a pc-ASPECT score <7 were more likely to present with impaired consciousness (P<0.001), multiple posterior circulation infarcts (P<0.001), hydrocephalus (P<0.001), lesions of the vermis (P=0.028), and peduncle (P=0.024), perfusion deficits in the total of posterior inferior cerebellar artery, anterior inferior cerebellar artery, superior cerebellar artery (P<0.05), and basilar artery stenosis (P=0.005), ischemia in additional anatomical structures in the posterior circulation (P<0.001) compared with those with a score ≥7.
Although the pc-ASPECT score alone is insufficient in some cases like vertebral artery dissection, using it together with the National Institutes of Health Stroke Scale (NIHSS) score and clinical findings may be beneficial during the hyperacute period of cerebellar ischemia. Presentation with impaired consciousness, basilar artery pathologies, vermian ischemia, and ischemia in additional anatomical structures in the posterior circulation other than the cerebellum appeared as important clinical and radiologic parameters predicting long-term prognosis.

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