Читать книгу Neurology - Charles H. Clarke - Страница 176

Features of cerebellar disease are well defined. With a lateral cerebellar lobe lesion, there is rebound and dysmetria in the ipsilateral limbs, dysarthria and nystagmus. With a vermis lesion, there is ataxia of stance, trunk & gait, sometimes with negative Romberg.

There are two practical points:

First, if an expanding cerebellar mass lesion is suspected or found on imaging, there must be speedy liaison with a neurosurgeon. While all brain mass lesions are potentially serious, many tumours above the tentorium can be dealt with in an expectant manner. With a cerebellar mass progression can take place over hours or less. Secondly, to misdiagnose as non‐organic the ataxia of stance and gait of a midline lesion does happen. See cerebellar syndromes: (Chapter 17).