Dados do Trabalho

Título

Don't lose your balance: what radiologists need to know about cerebellar ataxia.

Descrição sucinta do(s) objetivo(s)

This poster aims to provide a comprehensive exploration of the imaging patterns in cerebellar ataxia (CA). The main focus is on differentiating the causes and ruling out other potential diagnoses. The panel will mainly rely on the timing of symptoms (acute, subacute, chronic/congenital onset) as a primary tool to determine the etiology groups.
An algorithmic approach to cerebellar ataxia will be provided, which will serve as a systematic methodology for radiologists. This approach aims to guide in a step-by-step manner, allowing them to efficiently analyze and interpret imaging patterns associated with CA.

Descrição da(s) doença(s), método(s) e/ou técnica(s)

The diagnostic process for cerebellar ataxia involves a comprehensive clinical examination, including family history and physical evaluation, and laboratory and genetic testing. These approaches converge with brain MRI, where imaging patterns play a crucial role in narrowing differential diagnoses.

An initial step is distinguishing cerebellar-origin ataxia from other causes like vestibular neuritis, epileptic pseudoataxia, and conversion disorder. The second diagnostic step involves determining the onset duration: acute, subacute or chronic. The third step, pertinent only to chronic/congenital onset cases, involves classifying the cerebellar morphology into atrophic, dysplastic, or hypoplastic.

Discussão

In acute onset, cerebellar ataxia can result from a variety of causes, including ischaemic stroke, haemorrhagic events, infectious agents and autoantibodies to Purkinje cells (usually post-infectious).

Subacute onset cerebellar ataxia is often associated with neoplastic disease, such as medulloblastoma in children and posterior fossa meningioma in adults.

Chronic or congenital cerebellar ataxias include causes that morphologically present with hypoplasia, atrophy and dysplasia.

Hypoplasia includes cases such as Dandy-Walker syndrome, Joubert syndrome and ponto-cerebellar hypoplasia.

Cerebellar atrophy is the broader category and includes spinocerebellar ataxias and various mitochondrial and genetic disorders.

Cerebellar dysplasia, the rarest of the three, involves abnormal development and organisation of the cerebellar cortex. It includes conditions such as Lhermitte-Duclos disease, posterior fossa malformations and genetic syndromes.

Conclusões

There is no doubt that the importance of recognizing the diverse imaging patterns associated with the various etiologies of cerebellar ataxia is essential. By providing a structured, step-by-step approach, radiologists can improve their diagnostic accuracy and make informed decisions regarding patient care.

Palavras Chave

Cerebellar ataxia; Brain MRI; Neuroradiology.

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