Posterior inferior cerebellar artery syndrome

Head | Neurology | Posterior inferior cerebellar artery syndrome (Disease)


Description

Posterior inferior cerebellar artery syndrome is a particular type of stroke that is caused by decreased blood flow in the vertebral of posterior inferior cerebellar artery of the brain. The affected area of the brain is called the brainstem and patients experience problems with balance and speaking.

This syndrome is characterized by sensory deficits affecting the trunk (torso) and extremities on the opposite side of the infarction and sensory deficits affecting the face and cranial nerves on the same side with the infarct. Specifically, there is a loss of pain and temperature sensation on the contralateral (opposite) side of the body and ipsilateral (same) side of the face. This crossed finding is diagnostic for the syndrome.

Clinical symptoms include swallowing difficulty, or dysphagia, slurred speech, ataxia, facial pain, vertigo, nystagmus, Horner syndrome, diplopia, and possibly palatal myoclonus. The spinothalamic tract is damaged, resulting in loss of pain and temperature sensation to the opposite side of the body.

The damage to the cerebellum or the inferior cerebellar peduncle can cause ataxia. Damage to the hypothalamospinal fibers disrupts sympathetic nervous system relay and gives symptoms analogous to Horner syndrome.

Nystagmus and vertigo, which may result in falling, caused from involvement of the region of Deiters nucleus and other vestibular nuclei. Onset is usually acute with severe vertigo. Palatal myoclonus may be observed due to disruption of the central tegmental tract.

Causes and Risk factors

The posterior inferior cerebellar artery (PICA), the largest branch of the vertebral artery, is one of the three main arterial blood supplies for the cerebellum, part of the brain. Occlusion of the posterior inferior cerebellar artery or one of its branches, or of the vertebral artery leads to Wallenberg syndrome, also called lateral medullary syndrome.

Diagnosis and Treatment

A MRI and MRA is the best way to establish the diagnosis. Blood tests and other tests may be done depending on the findings of the imaging studies.

There is no specific cure but treatment is aimed at reducing symptoms and includes: aspirin, physical therapy, pain medications, and other supportive therapy. ...