RESUMO
We present the case of an 83-year-old woman with an isolated bilateral middle cerebellar peduncles stroke caused by complete occlusion of the right vertebral artery and focal occlusion of the left vertebral artery due to giant cell arteritis. The diagnosis was achieved by integrating MRI, ultrasound study, laboratory data and subsequent pathology analysis after biopsy of the temporal artery.
Assuntos
Infartos do Tronco Encefálico/etiologia , Arterite de Células Gigantes/complicações , Pedúnculo Cerebelar Médio/irrigação sanguínea , Artérias Temporais , Insuficiência Vertebrobasilar/etiologia , Idoso de 80 Anos ou mais , Biópsia , Infartos do Tronco Encefálico/diagnóstico por imagem , Feminino , Arterite de Células Gigantes/patologia , Humanos , Imagem Multimodal , Valor Preditivo dos Testes , Artérias Temporais/patologia , Insuficiência Vertebrobasilar/diagnóstico por imagemRESUMO
BACKGROUND: The prominent features of anterior inferior cerebellar artery (AICA) infarction are vertigo, cerebellar ataxia, and impaired hearing. The present study investigated neurological characteristics associated with AICA infarction. MATERIALS AND METHODS: The locations of infarcts in 7 patients (age, 32-72 years) with AICA infarction were divided into the lower lateral pons, the middle cerebellar peduncle (MCP), and the cerebellum. RESULTS: Ischemic lesions were located in the MCP in 6 patients, spread to the lower lateral pons in 3, and involved the cerebellum in 4 patients. Standing posture and gait were impaired in all patients. Five and 4 patients had impaired hearing and vertigo, respectively. Two patients had only symptoms of labyrinthine disease, and 1 had these symptoms accompanied by impaired hearing. The symptoms in 2 patients with the lesion in the lateral pons were consistent with those in Gasperini syndrome. Two of 3 patients without vertigo had ataxia of the extremities. Stenosis of the vertebral artery or basilar artery in 5 patients indicated that the etiology was branch atheromatous disease. CONCLUSIONS: The most prominent symptom of truncal and gait ataxia and the frequent association between vertigo and impaired hearing were consistent with the characteristics of AICA infarction. Two patients without vertigo had ataxia of the trunk and extremities that might have been due to involvement of the dorsal spinocerebellar tract in the inferior cerebellar peduncle.
Assuntos
Artérias Cerebrais/patologia , Infarto/complicações , Infarto/patologia , Vertigem/etiologia , Adulto , Idoso , Cerebelo/irrigação sanguínea , Cerebelo/diagnóstico por imagem , Artérias Cerebrais/diagnóstico por imagem , Feminino , Humanos , Infarto/diagnóstico por imagem , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Pedúnculo Cerebelar Médio/irrigação sanguínea , Pedúnculo Cerebelar Médio/diagnóstico por imagem , Exame Neurológico , Ponte/irrigação sanguínea , Ponte/diagnóstico por imagem , Estudos Retrospectivos , Fatores de RiscoRESUMO
Infarction of the symmetrical middle cerebellar peduncles is often induced by ischemic cerebrovascular disease. Adams described the anterior inferior cerebellar artery (AICA) syndrome as early as 1943, but clinical and imaging studies following this failed to shed more light regarding the condition until the advent of magnetic resonance imaging that comprehension regarding AICA improved significantly. Infarction of the middle cerebellar peduncles (MCP) is uncommon and the endovascular treatment of this condition is even more rare. We studied 4 patients with simultaneous bilateral cerebellar infarction of whom 2 received intracranial vascular therapy and demonstrated improvement in symptoms. Our findings suggest that patients with vertebral basilar artery stenosis with potential bilateral cerebellar infarction may benefit from endovascular treatment.