Background: Hemorrhagic transformation (HT) is a well-known consequence of acute ischemic stroke, but little is known about HT in cerebellar infarction. Methods: Patients with acute cerebellar infarction within 48 h of onset were retrospectively recruited. MRI, including diffusion-weighted imaging (DWI) and T2*-gradient echo imaging (T2*), was performed twice (upon admission and 2 weeks after stroke onset). Infarct diameter and volume were measured by manual tracing on initial DWI. HT was evaluated with follow-up T2*, and all patients were divided into two groups according to the presence of HT (HT group and non-HT group). The frequency of HT and the factors associated with HT were investigated. Results: Ninety-six patients (64 males, median age 74 years, IQR 65–81 years, and National Institute of Health Stroke Scale score 5, IQR 1–14) were enrolled. Forty-two patients (43%) showed HT on follow-up T2* (HT group). Infarct diameter and volume were larger in the HT group than in the non-HT group (3.2 vs. 1.6 cm, respectively, p < 0.001, for infarct diameter and 8.0 vs. 1.7 cm3, respectively, p < 0.001 for infarct volume). Multivariate logistic regression analysis revealed that both infarct diameter >2.7 cm (OR 7.58, 95% CI 2.82–20.4, p < 0.001) and volume >4.5 cm3 (OR 11.5, 95% CI 3.80–34.8, p < 0.001) were independent factors associated with HT. Conclusions: Half of the patients with acute cerebellar infarcts had HT on follow-up T2*. Initial infarct diameter and volume on DWI were independent factors associated with HT.

Keywords:
Cerebellar infarction, Hemorrhagic transformation, Magnetic resonance imaging, T2*-gradient echo imaging
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2011
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