Infarction in the Territory of Anterior Inferior Cerebellar Artery

Lee, Hyung; Kim, Ji Soo; Chung, Eun-Ji; Yi, Hyon-Ah; Chung, In-Sung; Lee, Seong‐Ryong; Shin, Je-Young

doi:10.1161/strokeaha.109.564682

Cited by 178 publications

(154 citation statements)

References 22 publications

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“…The combined peripheral and central vestibulopathy of insidious onset usually indicates a mass lesion involving the cerebellopontine angle [3]. In contrast, an infarction in the territory of anterior inferior cerebellar artery should be a prime suspicion when acute since this artery supplies both the central and peripheral vestibular structures [1,4,5]. However, a lesion restricted to the brainstem may also show typical features of peripheral vestibulopathy when the lesions are located in the vestibular root entry zone or the vestibular nuclei [6].…”

Section: Introductionmentioning

confidence: 99%

Isolated vestibular nuclear infarction: report of two cases and review of the literature

et al. 2013

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Cerebral infarction presenting with isolated vertigo remains a diagnostic challenge. To define the clinical characteristics of unilateral infarctions restricted to the vestibular nuclei, two patients with isolated unilateral vestibular nuclear infarction had bedside and laboratory evaluation of the ocular motor and vestibular function, including videooculography, bithermal caloric irrigation, the head impulse test (HIT) using magnetic scleral coils, and cervical and ocular vestibular-evoked myogenic potentials (VEMPs). We also reviewed the literature on isolated vertigo from lesions restricted to the vestibular nuclei, and analyzed the clinical features of seven additional patients. Both patients showed spontaneous torsional-horizontal nystagmus that beat away from the lesion side, and direction-changing gaze-evoked nystagmus. Recording of HIT using a magnetic search coil system documented decreased gains of the vestibular-ocular reflex for the horizontal and posterior semicircular canals on both sides, but more for the ipsilesional canals. Bithermal caloric tests showed ipsilesional canal paresis in both patients. Cervical and ocular VEMPs showed decreased or absent responses during stimulation of the ipsilesional ear. Initial MRIs including diffusion-weighted images were normal or equivocal, but follow-up imaging disclosed a circumscribed acute infarction in the area of the vestibular nuclei. Infarctions restricted to the vestibular nuclei may present with isolated vertigo with features of both peripheral and central vestibulopathies. Central signs should be sought even in patients with spontaneous horizontal-torsional nystagmus and positive HIT. In patients with combined peripheral and central vestibulopathy, a vestibular nuclear lesion should be considered especially when hearing is preserved.

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Section: Introductionmentioning

confidence: 99%

Isolated vestibular nuclear infarction: report of two cases and review of the literature

et al. 2013

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“…Clinical pictures vary according to the infarction localization in the infarctions compatible with AICA irrigation area. Whereas symptoms such as isolated vertigo mimicking labyrinthitis or ataxia are present in partial AICA, bilateral AICA may follow a severe clinical course which ultimately can cause coma ( 6,7,8). In our case, although bilateral involvement was present, it was not that severe.…”

Section: Discussionmentioning

confidence: 52%

“…In a study where thirteen AICA infarctions were presented, only three of them were bilateral (7). Lee et al (8) examined the relationship between AICA infarction and hearing loss in a study including 82 AICA infarction cases, and only 3 of them were bilateral. It is stated that AICA infarctions can be developed as a result of thrombotic stenosis in AICA due to atherosclerosis or obstruction of the plaque in basilar artery at the entrance of the AICA.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Anterior İnferior CerebellarArtery Infarction

Özkan¹,

Balcı²,

Şen³

et al. 2016

Türk Beyin Damar Hast Derg

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Anterior inferior cerebellar (AICA) infarctions are rarely seen, and bilateral AICA infarctions are mostly seen in the literature as case reports. Herein, a rare case with bilateral AICA infarction with severe vertigo, nausea and vomiting is presented. A sixty-nine-year-old woman was seen with the complaints of vertigo, tinnitus,nause, vomiting and hearing loss. In neurological examination, a dysarthric speech, horizontal nystagmus, bilateral peripheral facial palsy, right trigeminal hypoesthesia and mild ataxia were also noted. Mild sensorineural hearing loss (%30) was detected in the left ear through audiogram examination. In cranial MR imaging, a bilateral AICA infarction was reported. In addition, there were also bilateral hypoplastic posterior cerebral artery (PCA) and basilar artery stenosis in cranial MR angiography. The sympomts were partially disappeared following anti-platelet treatment. As in this case, in a patient with vertigo, AICA infarct should be kept in mind and detailed neurological examination should be performed.

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“…Patients with an injury of the SCA have dysarthria, which may be associated with mild ataxia, ipsilateral dissymmetry, and axial lateropulsion [2,10,11]. However, this cerebellar involvement spectrum that emerges from the injury of each one of the cerebellar arteries changes either little or substantially in the presence of some of the variant expressions reported in the present study, a first order circumstance for the diagnosis and management of clinical or surgical events that impair the blood supply to the cerebellum.…”

Section: Discussionmentioning

confidence: 99%

Differential distribution patterns in cerebellar irrigation. A study with autopsy material

2018

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Aim: The aim of this investigation was characterize morphologically the cerebellar artery and its branches in a specimen of autopsy material. Methods:This descriptive cross-sectional study evaluated the anatomical characteristics of the cerebellar arteries and their branches in 93 brain stem and cerebellum blocks obtained from fresh cadavers. The specimens were perfused bilaterally channeling the proximal segments of the internal carotid and vertebral arteries with a semi-synthetic resin (Palatal GP40L 85%; styrene 15%) impregnated with mineral red dye. We evaluated the distribution patterns of the cerebellar artery and its branches. Results:The calibers of the superior cerebellar artery (SCA), anterior inferior cerebellar artery (AICA) and posterior inferior cerebellar artery (PICA) were 1.46 ± 0.2 mm, 1.02 ± 0.35 mm and 1.45 ± 0.37 mm, respectively. Agenesis of the SCA was observed in six specimens (3.2%), AICA in 30 (16.1%), and PICA in 14 (7.5%) specimens. Usual irrigation was observed in 44 (47.3%) cerebellar blocks, whereas 49 (52.7%) specimens showed irrigation variants, 23 (46.9%) of which appeared bilaterally. The dominant distribution of the cerebellar arteries corresponded to SCA in 9 (12.5%) cases, AICA in 46 (63.9%) and PICA in 7 (9.7%) specimens; shared dominance was found in 10 (13.9%) specimens. Conclusion:The high variability of the cerebellar arteries observed in the present study is consistent with previous reports. The diverse anatomic expressions of the cerebellar arteries were typified in relation to their dominance and territories irrigated, useful for the diagnosis and clinical-surgical management of the cerebellum blood supply.

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Infarction in the Territory of Anterior Inferior Cerebellar Artery

Cited by 178 publications

References 22 publications

Isolated vestibular nuclear infarction: report of two cases and review of the literature

Isolated vestibular nuclear infarction: report of two cases and review of the literature

Bilateral Anterior İnferior CerebellarArtery Infarction

Differential distribution patterns in cerebellar irrigation. A study with autopsy material

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