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NEUROLOGY 2007;69:E4
© 2007 American Academy of Neurology
Resident and Fellow Section

Teaching NeuroImages Bilateral cerebellar infarction in dominant superior and anterior inferior cerebellar arteries

H. -Y. Choi, MD, M. G. Lee, MD, B. S. Ye, MD, H. J. Cho, MD, D. J. Kim, MD and J. H. Heo, MD, PhD

From the Departments of Neurology (H.-Y.C., M.G.L., B.S.Y., H.J.C., J.H.H.) and Diagnostic Radiology (D.J.K.), Yonsei University College of Medicine, Seoul, Korea.

Address correspondence and reprint requests to Dr Heo, Department of Neurology, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemoon-gu, 120-752, Seoul, Korea jhheo{at}yumc.yonsei.ac.kr

A 64-year-old man with diabetes mellitus presented with abrupt vertigo. MRI revealed an infarction in the bilateral cerebellum in the territory of the medial posterior inferior cerebellar artery (PICA) (figure, A), which is rare.1 Angiographic findings demonstrated that the infarction limited to the medial cerebellum was caused by the presence of rare variants of cerebellar arteries. They include the dominant anterior inferior cerebellar artery and the dominant superior cerebellar artery,2 which take over the territories that are usually perfused by the lateral PICAs (figure, B through D), along with the single medial PICA that supplies the medial areas of the bilateral cerebellum.


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  		Figure Imaging of the posterior inferior cerebellar artery

(A) Diffusion-weighted MRI demonstrates a bilateral infarction in the medial cerebellum. (B through D) Angiography shows an occlusion of the left posterior inferior cerebellar artery (PICA) (filled arrow), absence of the right PICA origin, and the presence of the dominant anterior inferior cerebellar artery (open arrows) and the superior cerebellar artery (arrowheads).

 

Received January 19, 2007. Accepted in final form March 6, 2007.

Supported by a grant from the Korea Health 21 Research and Development Project, Ministry of Health and Welfare, Republic of Korea (A060272).

Disclosure: The authors report no conflicts of interest.


   REFERENCES
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 REFERENCES
 

  1. Han SW, Cho GC, Baik JS, Park JH, Kim JY, Heo JH. Bilateral cerebellar infarction caused by dominant medial posterior inferior cerebellar artery. Neurology 2006;66:1125–1126.[Free Full Text]
  2. Newton TH, Potts DG. Radiology of the skull and brain. St. Louis: Mosby, 1974.




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