Superior cerebellar artery infarction


  • A 64 years old man
  • Underlying HPT, DM and old CVA
  • Complaint sudden onset giddiness, vomiting and nausea, tinnitus, unsteady gait with tendency to fall to left side.
  • Clinically: no neurological deficits, no cerebellar sign/nystagmus
  • CT scan was normal
MRI brain (A) axial T1WI, (B) axial T2WI and (C) coronal FLAIR
Axial MRI brain DWI/ADC sequences at different levels

MRI findings:

  • There is a large wedge shaped area of abnormal signal involving both grey and white matter of superior left cerebellar hemisphere.
  • It is hypointense to surrounding grey matter on T1WI, hyperintense on T2WI and FLAIR, demonstrates diffusion restriction, and is associated with effacement of adjacent sulci.
  • No compression of adjacent 4th ventricle.
  • No blooming artefact on GRE to suggest haemorrhage within

Diagnosis: Acute infarction of left superior cebellar territory.


  • Superior cerebellar artery arises near the termination of the basilar artery
  • It supplies superior part of the cerebellum, cerebellar vermis and part of the midbrain
  • Imaging features of stroke involve these regions
  • Occlusion at the origin of the artery produces the classic presentation of ipsilateral cerebellar (ataxia, dysarthria, nystagmus) and brainstem (Horner’s syndrome) signs associated with a contralateral dissociated sensory impairment.
  • Peripheral occlusion presents with solely ipsilateral cerebellar signs
Author: radhianahassan