Bilateral PICA Territory Infarcts of Right Lateral Medulla and Left Cerebellum via Spontaneous Common PICA Dissection
Jeon Kip-Young, 이청휘, 이기정, 최현석, 김범수, 고영진, 구자성,
소속 상세정보
( Jeon Kip-Young )
Catholic University Seoul St. Mary’s Hospital Department of Neurology
이청휘 ( Lee Chong-Hwee )
Catholic University Seoul St. Mary’s Hospital Department of Neurology
이기정 ( Lee Ki-Jeong )
Catholic University Seoul St. Mary’s Hospital Department of Neurology
최현석 ( Choi Hyun-Seok )
Yonsei University College of Medicine Severance Hospital Department of Radiology
김범수 ( Kim Bum-Soo )
Catholic University Seoul St. Mary’s Hospital Department of Radiology
고영진 ( Ko Young-Jin )
Catholic University Seoul St. Mary’s Hospital Department of Rehabilitation Medicine
구자성 ( Koo Ja-Seong )
Catholic University Seoul St. Mary’s Hospital Department of Neurology
Abstract
Bilateral cerebellar infarcts in posterior inferior cerebellar artery (PICA) territories have been previously reported and the common PICA (c-PICA) on one side was proposed as a possible mechanism. We report a case of bilateral PICA territory infarcts involving right lateral medulla and left cerebellum via spontaneous c-PICA dissection. Digital subtraction angiography (DSA) revealed that bilateral PICAs originated from the c-PICA arising from the right vertebral artery with luminal irregularity. Eccentric enhancement of the c-PICA on 3D multi-planar reformatted images suggested arterial dissection or atherosclerosis rather than vasculitis. Susceptibility-weighted image showed a blooming effect around the c-PICA and the phase map revealed eccentric high signal intensity on the vessel wall of the c-PICA, implicating intramural thrombus in c-PICA dissection. We investigated the mechanism and etiology of bilateral PICA territory infarcts using DSA and high-resolution magnetic resonance imaging (MRI) and elucidated the dissection of the c-PICA.
키워드
Cerebellar infarct; Lateral medullary infarct; Common PICA; Arterial dissection; High-resolution MRI
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