From the Guidelines
For patients presenting with cerebellar ataxia, MRI of the entire brain without and with IV contrast is the preferred initial imaging modality. This recommendation is based on the most recent evidence from the American College of Radiology Appropriateness Criteria, which emphasizes the importance of MRI in detecting parenchymal injury, volume loss, and alterations in signal intensity in the cerebellum and brainstem 1.
Key Considerations
- Cerebellar ataxia can result from various etiologies, including inherited, sporadic, toxic, nutritional, immune-mediated, infectious, and degenerative causes 1.
- Imaging plays a crucial role in detecting parenchymal injury and excluding non-degenerative central etiologies of ataxia, such as mass lesions or infarcts 1.
- MRI offers better visualization of the posterior fossa compared to CT and is particularly useful in detecting subtle cerebellar findings, such as mild parenchymal atrophy or architectural distortion 1.
- The use of susceptibility-weighted imaging or gradient echo T2-weighted sequences can help detect blood products in superficial siderosis, while diffusion-weighted imaging can assess for abscesses or highly cellular tumors 1.
Imaging Modalities
- CT head with IV contrast may be used in emergency settings, but it is less sensitive and specific than MRI for comprehensive evaluation of cerebellar ataxia 1.
- CTA and CTV head are not recommended as initial imaging tests for ataxia without a history of trauma, as they may delay appropriate care for suspected acute stroke 1.
- MRI with IV contrast is the preferred modality for initial assessment, as it provides better visualization of the cerebellum and brainstem, and can detect a wide range of abnormalities, including parenchymal injury, volume loss, and alterations in signal intensity 1.
From the Research
Cervella
There are no research papers to assist in answering this question about cervella, as the provided studies focus on levetiracetam and its use in epilepsy, as well as its potential effects on cognitive deficits in Alzheimer's disease.
- The studies 2, 3, 4, 5 discuss the mechanisms of action, efficacy, and safety of levetiracetam in treating epilepsy, including partial-onset seizures and idiopathic generalized epilepsies.
- Study 6 explores the potential of levetiracetam to attenuate cognitive deficits in Alzheimer's disease, suggesting it may be a promising treatment option.
- However, none of the provided studies mention cervella, making it impossible to provide a relevant answer based on the available evidence.