Analysis of Clinical Misdiagnosis of Cerebellar Infarction

WANG Haihong; WANG Shida; ZHANG Lina; ZHANG Xiaoyu

doi:10.3969/j.issn.1002-3429.2023.07.006

Abstract：Objective To explore the causes of misdiagnosis and preventive measures of cerebellar infarction.Meth-ods The clinical data of 10 patients with cerebellar infarction who were early misdiagnosed as vertebrobasilar artery insuffi-ciency and Meniere's disease admitted to our hospital from April 2020 to October 2022 were retrospectively analyzed.Results The initial symptoms of 10 cases were vertigo,nausea,vomiting,vision rotation in 4 cases,headache in 5 cases,difficulty in walking in 5 cases,tinnitus in 4 cases,and history of blood pressure in 6 cases.All cases had horizontal nystagmus,ac-companied by ataxia in 5 cases,hearing loss in 4 cases,peripheral facial paralysis in 1 case,hemiplegia in 3 cases,and hy-potonia in 2 cases.No responsible lesion was found in 10 cases after admission by head CT plain scan.Six patients underwent transcranial Doppler ultrasonography,which showed poor elasticity and slow blood flow of both vertebrobasilar arteries.The in-itial consideration was that there were 6 cases of insufficient blood supply to vertebrobasilar artery and 4 cases of Meniere's dis-ease.After corresponding symptomatic treatment,the symptoms did not improve significantly or even worsened.CT and MRI examination confirmed cerebellar infarction.The duration of misdiagnosis was 2-3 d.After diagnosis and symptomatic treat-ment,9 cases recovered well and 1 case had mild neurological symptoms.Conclusion Early symptoms of cerebellar infarc-tion are not typical,and it is more likely to lead to misdiagnosis at early stage.Clinicians should strengthen the understanding of the disease,perform conventional CT examination,and perform repeated CT or MRI examination when necessary,thus ef-fectively avoiding misdiagnosis.