Caveats in the management and diagnosis of cerebellar infarct and vertebral artery dissection.

Early MRI, available 24 h a day and at weekends, will make a timely diagnosis in cases of cerebellar infarct and a normal initial CT scan does not exclude it. In many emergency departments MRI is not as routinely available out of hours as CT. It is important to appreciate the varied symptomatology and signs of cerebellar infarcts in order to avoid misdiagnosis or delayed diagnosis and to remember that, apart from requiring treatment with anticoagulation for the cerebellar infarct itself, the complications of cerebellar infarct may require surgical intervention. Vertebral artery dissection as a cause of cerebellar infarct may require anticoagulation or endovascular therapy.