Topics:
Neurology • Vascular Neurology
How do you address incidental small cerebellar infarcts seen on MRI?
This is not an infrequent finding in outpatient neurology practice, often in the absence of any lacunar disease in the typical regions, though I usually see other evidence of small vessel disease. Are these infarcts attributable to small vessel disease or is evaluation for embolism typically indicated?
Answer from: at Academic Institution
I would obtain a CTA of the head and neck to look for vertebrobasilar disease. Probably too low yield to obtain an echocardiogram and Holter monitoring.
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Answer from: at Community Practice
I generally do the whole stroke workup; CTA and referral to cardiology.
Answer from: at Community Practice
I handle it similarly to how I would approach a symptomatic stroke, but I tend to conduct the workup as an outpatient. The exception arises if it's an acute case (DWI positive) that seems embolic; in such instances, I opt for an expedited inpatient workup.