OBJECTIVE: To explore the lesion patterns and stroke mechanism of the acute bilateral cerebellar infarct. PATIENTS AND METHODS: Patients admitted to Xiangyang Hospital with acute cerebellar infarcts, confirmed by diffusion-weighted imaging (DWI), were investigated. Patients were divided into two groups by lesions: unilateral cerebellar infarct (UCI) and bilateral cerebellar infarct (BCI). The demographic features, involved territories and concomitant lesions outside the cerebellum (CLOC). The causes were analyzed. RESULTS: Amongst the 115 patients hospitalized with posterior circulation cerebral infarct due to acute stroke, 56 patients had cerebellar infarct. There were 36 (64.3%) cases of unilateral cerebellar infarct and 20 (35.7%) cases of the BCI. The baseline information shows that stroke history (p = 0.002), fibrinogen (p = 0.036) and admission NIHSS score (M) (p = 0.001) for the BCI group are higher than the unilateral cerebellar infarct group. The incidence rate of cerebellar infarct in a posterior inferior cerebellar artery (PICA) blood supplying territory is the highest by divisions of vascular distribution. Unilateral cerebellar infarct occurs more often (p = 0.006); BCI is more common in PICA+SCA blood supplying territory (p = 0.004). The incidence rate of BCI merged with CLOC is much higher than the unilateral cerebellar infarct (p = 0.002). Merged infratentorial lesions are more common (p = 0.022) than BCI with atherosclerosis (p = 0.041). Offending artery diseases are mainly in the V4 segment of the vertebral artery, and in the severe stenosis or occlusion of V4 and BA junction. CONCLUSIONS: BCI was frequently involved in the PICA + SCA territory. Our results support the fact that embolism resulted from large artery atherosclerosis is the important stroke mechanism in the BCI.
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