Russell Mitesh Cerejo, MD
This Dutch Study by by Laurens JL et al. set out to answer a very crucial question in this age of advanced imaging. They looked at the prevalence of cerebellar cortical infarcts in a population with vascular risk factors. This was a subset study of the Second Manifestations of ARTerial disease-Memory depression and aging (SMART-Medea) study. In the span of 5 years they identified 636 patient that met their imaging and clinical criteria. One of more cerebellar cortical cavities were seen in 61 (~10%) of patients while cerebellar infarcts and cortical cavities were seen in 11%. The presence of cavities was significantly associated with age, intimal media thickening, hyperhomocysteinemia, cerebral infarct and brain atrophy. Interestingly no significant association was found between white matter hyperintensities or white matter lacunes of presumed vascular origin.
They also evaluated physical and mental functioning and found that cerebellar cavities were associated with a decrease in physical but not mental functioning. The authors suggest that cerebellar cortical cavities may be due to a large vessel disease since they were associated with surrogate markers of atherosclerosis (high IMT and hyperhomocysteinemia). Their study also suggested that most cerebellar infarcts could be small and escape clinical attention during acute stage of infarction.
