Infarctions of the brainstem and cerebellum: a correlation of computed tomography and angiography.

Forty-nine patients were found to have computed tomographic (CT) and clinical evidence for infarction in the brainstem and cerebellum. Seventeen had correlative angiography, of which 15 had a severe occlusive vascular lesion somewhere in the vertebrobasilar system. The correlation between angiographic and CT localization of the infarcts was not good. Inferiorly located infarcts were probably often missed on CT because of basal artifacts. Combined infarctions of the brainstem and cerebellum were common. Nineteen of the 49 patients had an associated mass effect in the posterior fossa; in eight of these, hydrocephalus developed. Although immediate surgical decompression of the posterior fossa has been recommended for treatment of this complication, most of these patients recovered well with careful medical decompression.