Left untreated, a cerebellar stroke can be life-threatening. According to the National Institute of Neurological Disorders and Stroke, Wallenberg Syndrome (aka Lateral Medullary Syndrome or Posterior Inferior Cerebellar Artery Syndrome) is a neurological condition caused by a blockage of the vertebral artery (VA) or posterior inferior cerebellar artery (PICA), ultimately leading to infarction of the later. Keywords: vertebral artery dissecting aneurysm, magnetic resonance. According to a 2015 review, they account for less than 10 percent of all strokes. Dissecting aneurysms frequently involve the vertebral arteries and their branches, but those involving the posterior inferior cerebellar artery (PICA) and. The vessels that reach this part of the brain include:Ī cerebellar stroke is a rare condition. A blood clot in any of these vessels can cause a stroke. There are a number of blood vessels that feed the cerebellum. Each side controls coordination and movement for the corresponding side of your body. All patients presented with acute myocardial infarction (MI) (26 ST-segment elevation MI STEMI, 74 NSTEMI) and approximately 70 reported an emotional or physical stressor. Vertebral artery dissecting aneurysm (VADA) involving the origin of the posterior inferior cerebellar artery (PICA) is a complex disease entity in which the dual goals of preventing future rebleeding and maintaining perfusion of the lateral medulla must be considered. Mean age was 52.5 9.6 years and 91 were women (57 were post-menopausal). It’s located at the back of your brain, at the bottom. Results: A total of 327 patients were enrolled from 2012-2106. The cerebellum is the portion of the brain that controls movement and maintains balance. It’s also referred to as cerebellar stroke syndrome. A complex abnormality of the right PICA is shown - shortly after its origin there is an eccentric high-grade stenosis with small false aneurysm, and some 10 mm beyond this is a smaller 3 mm mixed fusiform and saccular aneurysm, just beyond this a larger 4.5 millimeter aneurysm at the bifurcation of PICA, incorporating both branches in its base. This type of stroke typically affects only one side or section of the cerebellum. It occurs when a blood vessel is blocked or bleeding, causing complete interruption to a portion of the cerebellum. All rights reserved.A cerebellar stroke is one of the less common types of strokes. once the artery is ruptured with SAH, high morbidity and mortality rates. Given the dynamic clinical course and potential fatality of PICA dissection, meticulous evaluation, intensive treatment with a diverse range of modalities, and proper follow-up are required for patients with PICA dissection to achieve favorable outcomes.Ĭoil embolization Isolated PICA dissection OA-PICA bypass surgery PICA dissecting aneurysm Trapping.Ĭopyright © 2016 Elsevier Inc. DISSECTING ANEURYSMS The natural history of dissecting vertebral artery. In addition, the other 2 patients (1 in each group) died as a result of major SAH. Although 7 patients showed relatively good outcomes (modified Rankin Scale score, ≤2) after 30 days of follow-up, 1 patient had a final modified Rankin Scale score of 3. Endovascular treatment was performed in 1 patient, who showed rapid progression, aneurysm formation, and conversion to massive SAH within 10 days after the initial attack. Among the 3 patients with infarction, 2 received conservative treatment. Conservative management was performed in the other 2 patients. Because of involvement of the brainstem and cerebellum, most survivors have multisystem dysfunction (eg, quadriplegia or hemiplegia, ataxia, dysphagia, dysarthria, gaze abnormalities, cranial. Most reported cases of PICAD present with subarachnoid haemorrhage (SAH) or intraventricular haemorrhage (IVH), rather than with ischaemic stroke. Dissection was seen at the proximal portion in 8 patients, whereas the remaining 2 patients showed distal PICA dissecting aneurysms.Īmong the 7 patients with hemorrhage, 5 were actively treated (trapping and bypass, 2 patients surgical clipping, 1 patient coil embolization, 2 patients). Isolated posterior inferior cerebellar artery (PICA) dissection (PICAD) is a rare condition. Ten patients were enrolled, including 7 patients with subarachnoid hemorrhage (SAH) and 3 with PICA territory infarction. We retrospectively reviewed the clinical records of all patients who underwent any PICA dissection treatment in our institute over the last 4 years. However, because of the rarity of these dissections, the optimal treatment has not yet been established. Isolated dissections that develop on the posterior inferior cerebellar artery (PICA) require intensive treatment because of their potential fatality.

Pica artery dissection survival