Differential Diagnosis for Cerebellar Bleed
- Single most likely diagnosis
- Hypertensive intracerebral hemorrhage: This is the most common cause of cerebellar hemorrhage, often related to long-standing hypertension that leads to the formation of Charcot-Bouchard aneurysms which can rupture and cause bleeding.
- Other Likely diagnoses
- Arteriovenous malformation (AVM): AVMs are abnormal connections between arteries and veins, which can rupture and cause bleeding in the cerebellum.
- Cerebellar infarction with hemorrhagic transformation: Initially, a cerebellar stroke (infarct) may not show bleeding, but over time, the infarcted area can undergo hemorrhagic transformation.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Aneurysm: Although less common in the posterior circulation, an aneurysm could rupture and cause a cerebellar bleed, necessitating urgent intervention.
- Cerebral venous sinus thrombosis: This condition involves a blood clot in the venous sinuses and can lead to cerebral hemorrhage, including in the cerebellum.
- Hemorrhage due to anticoagulation: Patients on anticoagulant therapy are at increased risk of bleeding, including intracerebral hemorrhage, which could occur in the cerebellum.
- Rare diagnoses
- Cerebellar tumor with hemorrhage: Certain tumors, such as hemangioblastomas or metastases, can bleed and present as a cerebellar hemorrhage.
- Vasculitis: Inflammation of the blood vessels (vasculitis) can lead to vessel wall weakening and rupture, causing a hemorrhage.
- Moyamoya disease: A rare condition causing narrowing or blockage of the internal carotid artery and its branches, leading to a possible hemorrhage, including in the cerebellum, though it's more commonly associated with anterior circulation.