Cerebellar Stroke: What Are the Effects & How Can Survivors Recover?

A cerebellar stroke is rare. In fact, less than 2% of all strokes occur in the cerebellum. This means that cerebellar stroke survivors must be diligent about asking the right questions during recovery.

To help prepare you for the road to recovery, you’re about to learn the unique symptoms and secondary effects that may occur after a stroke in the cerebellum. You’ll also discover the best practices for rehabilitation along with a rough timeline to help you ask better questions next time you see your doctor.

Table of contents:

• Symptoms
• Effects
• Prognosis
• Rehabilitation
• Timeline

Symptoms of Cerebellar Stroke

A stroke occurs when the supply of blood to the brain is compromised by either a clogged artery or burst artery. When stroke happens in the cerebellum, it’s called a cerebellar stroke.

The hallmark symptoms of a stroke include facial drooping, weakness in one arm, and slurred speech. However, cerebellar stroke often results in much different symptoms, which should be treated as a medical emergency.

Signs and symptoms of cerebellar stroke include:

• Vertigo*
• Vomiting
• Dizziness
• Lethargy
• Headache
• Muscle weakness or paralysis
• Vision problems

*About 3% of people rushed to the emergency room for vertigo are actually having a cerebellar stroke. Doctors should be encouraged to order brain scans when patients show signs of vertigo.

Next, we’ll talk about the cerebellum and the potential effects of cerebellar stroke.

Secondary Effects of a Stroke in the Cerebellum

Generally, the cerebellum is known to control coordination of voluntary movements, maintenance of balance and posture, motor learning, and some aspects of language.

When a stroke occurs in the cerebellum, it can damage any or all of these functions.

Notably, cerebellar strokes often lead to impairments in motor control and posture, because the majority of the cerebellum’s outputs are to parts of the motor system.

However, other effects are possible. Here are the most common secondary effects of a cerebellar stroke:

• Acute cerebellar ataxia: a lack of control over voluntary movements
• Loss of coordination and balance: which usually results from ataxia
• Vertigo: feeling like the world is spinning
• Nausea and vomiting: which can stem from other cerebellar stroke effects like vertigo
• Cerebellar cognitive affective syndrome: involves executive, linguistic, and visual spatial impairments
• Impaired memory: cerebellar strokes do not erase memory, but they can impair ability to recall information
• Difficulty with proprioception: not knowing where your limbs are in relation to the world around you
• Speech problems like aphasia or ataxia of speech
• Eye movement disorders like double vision or nystagmus (rhythmic shaking of the eye(s) side-to-side, up-and-down, or in circular motions)

Cerebellar stroke patients should work closely with their rehabilitation team to diagnose and rehabilitate as much of the after math as possible. When inpatient and outpatient therapy is not adequate, patients need to participate in at-home therapy as well.

Before we discuss rehabilitation methods for cerebellar stroke recovery, let’s preview the prognosis.

Prognosis for a Stroke in the Cerebellum

In the stroke rehabilitation field, we know one thing for certain: every stroke is different, and every recovery will be different. No stroke is the same. Everyone’s brain is wired a bit differently, and every stroke affects the brain differently.

Although it’s hard to predict the outcome of any single stroke, there are a few main things that will affect the prognosis:

• The size of the stroke: Was it a minor stroke, moderate stroke, or massive stroke?
• The area of the brain affected by stroke: Was it just the cerebellum that was affected, or were other areas involved?
• The appropriateness of rehabilitation: Were the best practices implemented? Was enough time and intensity spent on rehabilitation?
• The person’s prior level-of-function: The more active and independent the patient was prior to their stroke, the better their prognosis for recovery.

Work with your medical team to get these questions answered. For instance, you can gain insight about the size and severity of your stroke by asking if your NIH Stroke Scale score was measured at the hospital.

Even if you cannot get answers to these questions, you can still make the most of rehabilitation by following the best practices, which we will discuss next.

Cerebellar Stroke Rehabilitation Methods

The appropriateness and intensity of rehabilitation makes a big difference in recovery. Taking the right steps can help patients maximize their outcomes.

Here are some of the best practices for rehabilitation after cerebellar stroke:

• Physical therapy. When cerebellar stroke affects voluntary movement, physical therapy can help retrain the brain to control those muscles.
• Massed practice. This mean practicing physical therapy exercises with high repetition. This intensity of rehabilitation helps stimulate the brain and spark neuroplasticity: the mechanism the brain uses to reorganize itself and learn new skills.
• Core and balance training. Physical therapists may recommend specific core and balance exercises for cerebellar stroke patients to practice at home. These problem areas may improve with daily exercises.
• Speech therapy. When cerebellar stroke patients sustain language difficulties like ataxia of speech, speech therapy can help. A Speech-Language Pathologist can help diagnose your condition(s) and create an exercise plan suited for your specific needs.
• Cognitive training. If executive function like memory has been affected, then cognitive training exercises may help. Apps like the CT Speech & Cognitive Therapy App help address both speech and cognitive training.
• Occupational therapy. If poor coordination, balance, and/or other impairments from cerebellar stroke have impacted your ability to engage in activities of daily living, occupational therapy can help. In this training, you will re-learn how to do things like get dressed, shower, shave, etc. before moving on to more complicated tasks.
• Vision training. When vision has been affected, it is often possible to at least partially regain your sight after a stroke through vision training. This involves practicing specific eye exercises such as visual scanning. The goal is to stimulate the brain and improve the brain’s ability to process visual input.

When possible, enlist the help of a therapist or other qualified specialist. If your resources are limited, you can consult with a therapist for a limited time, and continue their best practices on your own at home.

A great way to stay motivated with at-home therapy is to use interactive home therapy devices like FitMi. It provides exercises based on your unique ability level and motivates you to accomplish high repetition.

See what a cerebellar stroke survivor recently said about FitMi:

“My family purchased FitMi for our brother who suffered a cerebellar stroke. He describes the FitMi as a challenging workout and is experiencing improvements all the time!! He had a very serious rare stroke with damage to both legs as well as left arm. The FitMi has been given him the ability work everyday at home while continuing therapy as an outpatient too.” -Susan’s FitMi review

FitMi helps you accomplish high repetition of therapeutic exercises, which helps activate neuroplasticity. When done on a regular basis, recovery tools like these can help supplement outpatient therapy with at-home exercise so that survivors see faster improvement in mobility.

The road to recovery can be short or long depending on the severity of your stroke and how intensively you pursue rehabilitation. Next, we will discuss the timeline in more detail.

Cerebellar Stroke Recovery Time

No one can say with certainty how long it takes to recover from stroke. Every stroke is different and every recovery is different. However, the timeliness and intensity of rehabilitation make a difference.

During the first 3 months after a stroke, the brain is in a heightened state of plasticity. It recovers faster during this time, which explains why many patients experience a plateau after the 3 month mark.

Stroke patients also benefit from inpatient therapy during the first few months of recovery. Inpatient therapy is intensive and requires hours of therapy each day. This intense workload is another reason why stroke patients tend to recover rapidly in the beginning.

Unfortunately, the lack of adequate home therapy is one reason why many stroke patients are at the same level of recovery at the 5 year mark as they were at the 3 month mark.

You can avoid this severe slowdown in results by participating in a motivating at-home therapy program on a regular basis. For example, Flint Rehab’s FitMi home therapy suite encourages daily physical therapy exercise, which helps patients see faster results.

Other programs can help with speech or cognitive rehabilitation, such as the CT Speech & Cognitive Therapy app.

Experiment with different methods until you find what works for you.

Recovering from Cerebellar Stroke

The most common secondary effects of a cerebellar stroke involve loss of balance and ataxia of speech. Fortunately, regular physical therapy and speech therapy, respectively, can help patients recover from these side effects.

Experts are not sure about the extent to which cerebellar stroke patients can recover. However, the brain is capable of amazing things. When the cerebellum becomes damaged, recovery is possible through the phenomenon of neuroplasticity.

Neuroplasticity requires “massed practice” to get started and keep going. Inpatient therapy is not enough to help patients maximize their potential. Instead, a motivating at-home therapy regimen should be pursued for optimal results.