Trepet H. Isolated cerebellar infarctions: peculiarities of ataxic and neuropsychological disorders in the dynamics of treatment in acute and recovery periods

The dissertation is devoted to the peculiarities of the restoration of the lost coordinative functions according to affected vascular territory of the cerebellum, the available clinical and MRI signs of crossed cerebellar-hemispheric diaschisis and without it in patients with isolated infarction of the cerebellum in acute and recovery periods. According to the results of a comprehensive study of 60 patients with isolated cerebellar infarctions in acute and recovery periods, it was found that cerebellar infarcts were mainly located in the territorу of the medial or lateral branches of SCA (54,4%), in the medial branch of PICA (30,4%) and less frequently – in the territory of AICA (8,8%) and in the lateral branch of PICA (6,4%). It is proved that ataxic disorders in acute isolated cerebellar infarctions have been associated with affected specific arterial territories and were significantly different by specific symptoms. Obligate symptoms of the infarction in the territory of superior cerebellar artery were dysarthria, limb ataxia, intention tremor; infarctions in the territory of posterior inferior cerebellar artery characterized by vertigo, gait ataxia, lateropulsion, horizontal nystagmus; infarctions in the territory of anterior inferior cerebellar artery characterized by vertigo, vestibular disorders, sensoneural hypoacusis, spontaneous nystagmus. The analysis identified the neuropsychological disorders in patients with acute isolated cerebellar infarctions with the usage of a special battery of subtests to assess gnosis, praxis, speech, memory, attention and executive functions as well as study of the features of neuropsychological disorders in patients with acute isolated cerebellar infarction depending on the affected vascular territory. The relationship between ataxic symptoms in patients with acute isolated cerebellar infarctions and distant focal cerebellar symptoms due to the development of crossed cerebellar-hemispheric diaschisis were ascertained. We evaluated the features and patterns of recovery of lost ataxic functions in different periods of treatment after isolated cerebellar infarction with clinical signs of crossed cerebellar-hemispheric diaschisis and without it