Syndrome of the Posterior Inferior and Anterior Inferior Cerebellar Arteries and Their Branches

Goodhart, Sandor

doi:10.1001/archneurpsyc.1936.02260030073004

Cited by 63 publications

(11 citation statements)

References 10 publications

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“…6,13 Furthermore, cerebellar involvement was noted in only 1 of 8 patients with isolated PICA disease, illustrating the effectiveness of the collateral circulation in the cerebellum through the AICA or the superior cerebellar artery. 12 In our study, VA stenosis or occlusion was the most common angiographic feature. Short-segment VA stenosis tended to produce a medium-sized, diagonal band-shaped lesion usually confined to the dorsolateral part of the rostralmiddle medulla or lateral superficial portion of the caudal medulla.…”

Section: Discussionmentioning

confidence: 47%

“…The lesion was located at various rostral-caudal levels of the medulla, which may result from various levels of PICA origin at the VA, 11 various lengths of the ascending loop of PICA, 12 different degree of collateralization from other vessels such as the VA or the AICA, 11 and different levels of the occlusion of penetrating branches from the PICA (Fig 10). The most dorsal part of the caudal medulla was usually spared.…”

Section: Discussionmentioning

confidence: 99%

“…The MRI lesion in these patients was similar in shape and size to that produced by isolated PICA disease, suggesting that the lateral medulla supplied by the medial PICA may have poor collateral circulation. 12 Thus, it seems that not only the length of the involved VA segment but also the speed of development of the vascular lesion determine the eventual size of the infarct and consequent clinical syndromes.…”

Section: Discussionmentioning

confidence: 99%

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Patterns of Lateral Medullary Infarction

Kim

Lee

Choi

1998

Stroke

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Background and Purpose-Correlation of MRI findings with various vascular pathologies has rarely been attempted in patients with lateral medullary infarction (LMI). The aim of the present study was to correlate the diverse MRI lesions with the vascular lesions seen on conventional cerebral angiography in LMI. Methods-The subjects included 34 patients with LMI who underwent both MRI and conventional angiography. We analyzed the risk factors, clinical features, MRI findings, and angiography results. The size of the infarction was also measured. We attempted to correlate the MRI findings with the vascular lesions shown in the angiograms. Results-Presumed causes for infarction were atherothrombosis in 19 patients, arterial dissection in 8, cardiogenic embolism in 3, moyamoya disease in 1, small-vessel disease in 1, and embolism of unknown source in 2. Isolated posterior inferior cerebellar artery (PICA) disease (nϭ8) was usually associated with atherothrombosis and correlated with thin, round, or diagonal band-shaped lesions in the lateral-superficial area of the caudal medulla and/or dorsolateral portion of the rostral-middle medulla. Short-segment distal vertebral artery (VA) disease (nϭ9) was usually due to atherothrombosis and correlated with small lateral caudal and/or medium-sized, diagonal band-shaped rostral-middle medullary lesions. There were 13 patients with long-segment VA disease sparing (nϭ8) or involving (nϭ5) the proximal part of the VA with concomitant occlusion of the PICA in 7 patients. This vascular lesion produced either large MRI lesions extending ventrally (nϭ5; 4 were associated with VA dissection) or small lesions mimicking those produced by isolated PICA disease (nϭ8; 6 were associated with atherothrombosis and 1 patient had moyamoya disease). These large MRI lesions characteristically produced bilateral or contralateral trigeminal sensory involvement. Normal angiogram (nϭ4; 3 patients were presumed to have cardiac embolism, one lesion was associated with small-vessel infarction) was associated with small, round lesions that produced minor and fragmentary symptoms. Among these subgroups, the size of the infarct in the patients with long-segment VA disease due to dissection was significantly larger than that of the patients with other vascular lesions. Conclusions-Our data suggest that the heterogeneous MRI lesions (and consequent clinical syndromes) of LMI are correlated with diverse angiographic findings, which in turn are due to different pathogenic mechanisms: etiology, location and size of the involved vessels, speed of the lesion development, and status of collateral channels. Generally, infarcts related to multiple vessel involvement, dissection, and poor collateral circulation are larger than those associated with single-vessel disease, long-standing atherothrombosis/cardiac embolism, and good collateralization. (Stroke. 1998;29:645-652.)

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Section: Discussionmentioning

confidence: 47%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Patterns of Lateral Medullary Infarction

Kim

Lee

Choi

1998

Stroke

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“…G oodhart and Davison [1] first described an autopsy case in which cerebellar symptoms had devel oped due to partial obstruction of the ipsilatcral AICA. They commented that coexisting multiple vascular insults could complicate the diagnosis of the AICA syndrome.…”

Section: Discussion Illustrative Casesmentioning

confidence: 99%

“…In our series, unilateral hearing im pairm ent was the most crucial sign for diagnosis of the AICA syndrome. Results for the auditory brain stem response suggested that the hearing im pairm ent may be partly attributable to chochlear ischemia.Infarction in the posterior fossa occurs most com monly in the distribution of the posterior inferior cerebel lar artery (PICA) [1][2][3][4][5]. Infarctions in the anterior inferior cerebellar artery (AICA) territory are known to be rare.…”

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confidence: 99%

Infarction in the Anterior Inferior Cerebellar Artery Territory: Magnetic Resonance Imaging and Auditory Brain Stem Responses

Matsushita¹,

Kazui²,

Watanabe³

et al. 1993

Cerebrovasc Dis

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Infarction in the anterior inferior cerebellar artery (AICA) territory is rare, and most reports on such infarction have been restricted to autopsy studies. We analyzed the clinical figures of 5 patients with AICA territory infarction diagnosed by magnetic resonance imaging (MRI). They all developed dizziness or vertigo, unilateral ataxia and homolateral hearing impairment. The MRI demonstrated ischemic lesions in the ipsilateral middle cerebellar peduncle. All patients showed excellent neurological recovery and were ambulatory at discharge. In our series, unilateral hearing impairment was the most crucial sign for diagnosis of the AICA syndrome. Results for the auditory brain stem response suggested that the hearing impairment may be partly attributable to chochlear ischemia.

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Cerebellar Infarction With Brain Stem Compression

Lehrich¹

1970

Arch Neurol

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Syndrome of the Posterior Inferior and Anterior Inferior Cerebellar Arteries and Their Branches

Cited by 63 publications

References 10 publications

Patterns of Lateral Medullary Infarction

Patterns of Lateral Medullary Infarction

Infarction in the Anterior Inferior Cerebellar Artery Territory: Magnetic Resonance Imaging and Auditory Brain Stem Responses

Cerebellar Infarction With Brain Stem Compression

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