Injury of the vestibulocerebellar tract in a patient with intracerebral hemorrhage: A case report

•Intracerebral hemorrhage (ICH) in the cerebellum is accompanied by ataxia and vertigo.•Vestibulocerebellar tract (VCT) perceives head and body motion in the spatial direction.•Diffusion tensor imaging (DTI) enables the investigation of injuries of cerebellum in patients with ICH.•VCTs injury following ICH in both the cerebellar hemispheres seems to be related to ataxia.•Evaluation of VCT using DTI might be useful for patients with ataxia following ICH in the cerebellum. The vestibulocerebellar tract (VCT) is an important pathway of the central vestibular system, and plays a role in posture reflexes as well as perception of the head and body motion in spatial direction. We report on a patient with intracerebral hemorrhage (ICH), who showed injury of the VCT, which was demonstrated by diffusion tensor imaging (DTI). This study recruited an 81-year-old male patient presented with quadriparesis due to ICH on both cerebellar hemispheres and 5 control subjects. A patient had the dizziness that was occurred when he moved and the motor weakness in lower limb. The primary and secondary VCTs of a patient with total 25 score of Scale of the Assessment and Rating of Ataxia were reconstructed using DTI. The results of DTI parameters of primary VCT showed that the tract volumes of primary VCT in both hemispheres of a patient showed significant decrease compared to those of control subjects. All of DTI parameters of ipsilateral secondary VCT in left hemisphere of a patient were within the reference range. Additionally, the ipsilateral secondary VCT in right hemisphere and the contralateral secondary VCTs in both hemispheres of a patient were not reconstructed. We suggest that a patient’s ataxia appears to be related to injury of the VCT. Therefore, we believe that the current study would be helpful in evaluating and clinical managing patients with ataxia following cerebellar injury.