Combination of infarctions in the posterior inferior cerebellar artery and anterior spinal artery territories.
After an episode of vasodilator-induced systemic hypotension, a 75-year-old man developed ocular lateropulsion to the right, left-side-dominant quadriparesis, loss of superficial sensation below C4 dermatome level, and anuresis. Magnetic resonance imaging (MRI) showed infarcts in the right cerebellar hemisphere (posterior inferior cerebellar artery territory) and the upper cervical cord (anterior spinal artery territory); the combination of posterior inferior cerebellar artery (PICA) and anterior spinal artery (ASA) infarcts has not been reported previously. Angiography revealed severe stenosis in the bilateral vertebral arteries. Hemodynamic hypoperfusion of the stenotic vertebral arteries may cause this unusual combination.
Johkura
Ken
K
Department of Neurology, Hiratsuka Kyosai Hospital, 9-11 Oiwake, Kanagawa, Japan. johkura_k@kkr.hiratsuka.kanagawa.jp
Joki
Hideto
H
Johmura
Yuji
Y
Momoo
Takayuki
T
Kuroiwa
Yoshiyuki
Y
D000368:Aged; D020759:Anterior Spinal Artery Syndrome / Q000175:diagnosis*; D006801:Humans; D014854:Lateral Medullary Syndrome / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male