Vertigo secondary to isolated PICA insufficiency: successful treatment with balloon angioplasty.
BACKGROUND
The posterior inferior cerebellar arteries (PICA) arise from the intracranial segments of the vertebral artery (VA). We report a case where a nondominant isolated vertebral artery, which terminated in PICA, was stenotic. This resulted in brainstem-lower cerebellar ischemia, corrected with balloon angioplasty.


METHODS
A 62-year-old male presented primarily with transient vertigo, syncope, and dizziness and was diagnosed with transient ischemic attack. Angiography of the left vertebral artery (VA) demonstrated a small-caliber vessel terminating in PICA with a 90% stenosis at the C6 level. Angioplasty of the left VA was performed with excellent resolution of the stenosis.


CONCLUSIONS
This case illustrates cerebellar insufficiency in a unique case where the PICA was isolated, supplied by a small- caliber VA. Correction of the stenosis improved the patient's symptomatology and prevented an inferior brainstem-cerebellar infarction.
D000800:Angioplasty, Balloon; D002526:Cerebellar Diseases / Q000150:complications / Q000628:therapy; D002531:Cerebellum / Q000098:blood supply*; D003251:Constriction, Pathologic / Q000150:complications / Q000628:therapy; D004244:Dizziness / Q000209:etiology; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications* / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020769:Posterior Cerebral Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D013575:Syncope / Q000209:etiology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014717:Vertigo / Q000209:etiology*