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Emergency Medical Minute


Jul 6, 2019

Contributor: Jared Scott, MD

Educational Pearls:

  • Cerebellar strokes make up a disproportionate number of missed or delayed diagnosis for stroke likely due to the subtle nature of the presentation
  • Cerebellar strokes can present with vomiting, dizziness, and ataxia. 
  • Unlike anterior circulation stroke, exam findings in a cerebellar stroke are ipsilateral to the lesion 
  • On neuro exam, findings may include:
    • Dysmetria: lack of coordination with overshooting/undershooting intended position of limb
    • Dysdiadochokinesia: difficulty with rapid alternating movements
    • Ataxia
    • Nystagmus
  • Consider a cerebellar stroke in patients presenting with vomiting and dizziness without an alternative diagnosis


Edlow JA, Newman-Toker DE, Savitz SI. Diagnosis and initial management of cerebellar infarction. Lancet Neurol. 2008 Oct;7(10):951-64. doi: 10.1016/S1474-4422(08)70216-3. Review. PubMed PMID: 18848314.

Datar S, Rabinstein AA. Cerebellar infarction. Neurol Clin. 2014 Nov;32(4):979-91. doi: 10.1016/j.ncl.2014.07.007. Epub 2014 Sep 13. Review. PubMed PMID: 25439292.

Summarized by Will Dewispelaere, MS4 | Edited by Erik Verzemnieks, MD