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From the Labratoire de Neuropathologie Raymond Escourolle, Formation Associée de L'Assoeiation Claude Bernard, Hõpital de la Salpêtrière (Dra. Amarenco and Hauw), and Service de Neurologie, Hôpital Saint-Antoine (Dr. Amarenco), Paris, France.
We reviewed the clinical and pathologic findings in 33 patients with infarcts in the territory of the superior cerebellar artery (SCA). The clinical manifestations included the rostral basilar artery syndrome (8); coma at onset, often with tetraplegia (11); cerebellar and vestibular signs (9, with delayed coma due to cerebellar swelling in 6); and, in only 1 patient, the "classic" syndrome of the SCA. Clinical features were overshadowed by an infarct in the territory of the middle cerebral artery in 3 other patients, and the diagnosis was made only at autopsy in a fourth. Pathologically, SCA infarcts occurred in isolation in 7 patients. The most striking finding was the high frequency of associated infarcts in the territory of the rostral part of the basilar artery (73%). One-third of patients also had an infarct in the territory of the posterior inferior cerebellar artery, sometimes associated with infarction of the anterior inferior cerebellar artery. Tonsillar herniation was observed in 15 patients, 8 of whom had no infarcts in other cerebellar territories. Occlusions occurred mainly in the distal basilar artery and distal vertebral artery. The infarcts were mostly caused by cardiac and artery-to-artery emboli.
Address correspondence and reprint requests to Dr. Pierre Amarenco, Service de Neurologie, Hôpital Sainte-Antoine, 184 rue du Faubourg Saint-Antoine, F-75571 Paris Cédex 12, France.
Received September 13, 1989. Accepted for publication in final form March 8, 1990.
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