Case 15.1 Sudden onset of unilateral ataxia

1. Patient history

1.1. Hypertension

1.2. Sudden onset of symptoms

2. Possible Diagnoses

2.1. Infarct of left cerebellum arteries (most likely)

2.1.1. SCA

2.1.1.1. Ipsilateral ataxia

2.2. Left cerebellar hemorrhage

2.3. Left cerebellar abscess

2.4. Acute lesion to a cerebellar peduncle

2.5. Lesion from the left cerebellar hemisphere to left cerebellar peduncle

3. MRI

3.1. Infarct to left SCA

4. Key symptoms

4.1. Left arm and leg ataxia

4.1.1. Causes

4.1.1.1. Appendicular ataxia

4.1.1.2. Ipsilateral cerebellar lesion to the left cerebellar hemisphere

4.1.1.3. Lesion of one of of the left cerebellar peduncles

4.2. Unsteadiness, falling to the left

4.2.1. Causes

4.2.1.1. Truncal ataxia

4.3. Slurred speech

4.3.1. Causes

4.3.1.1. Cerebellar lesions

4.4. Nausea and vomiting

4.4.1. Causes

4.4.1.1. Cerebellar lesions

4.4.2. Involvement

4.4.2.1. Cerebellar-vestibular circuits

5. Clinical localization

5.1. Left cerebellar hemisphere and vermis

5.2. Left superior, middle or inferior cerebellar peduncle

6. Recovery

6.1. Ataxia improved

6.2. 1 week post injury, speech returned

6.3. Ambulating with assist from PT

6.4. Entered into a RCT

6.4.1. Asprin is as effective as Coumadin for reoccurring strokes