Anterior inferior cerebellar artery syndrome due to vertebral artery dissection following minimal neck injury: a case report

Abstract

We report a case of anterior inferior cerebellar artery (AICA) syndrome due to vertebral artery dissection following a minimal neck injury. The patient was a 16-year-old male who developed a throbbing headache in the left occipital area during sumo sparring. He endured the headache and continued to practice sumo on successive days. Three days later, he developed vertigo, right hearing loss, and right tinnitus soon after impacting an opponent during sparring. The patient was admitted to our hospital with suspicion of sudden deafness. The following morning, he developed right peripheral facial paralysis, hypothermoesthesia and hypoalgesia of the right face, and cerebellar ataxia of the right upper limb and trunk. Diffusionweighted MRI showed high signal intensity in the territory of the right AICA and the right posterior inferior cerebellar artery (PICA). MRA showed left vertebral artery occlusion, basilar artery stenosis, and right AICA occlusion. An anticoagulant and edaravone were immediately administered. Twenty days later, cerebral angiography showed recanalization of the right AICA. Some symptoms gradually improved, but right hearing loss and truncal ataxia remained. This case suggests artery-to-artery embolism from vertebral artery dissection as a possible mechanism of AICA syndrome.