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June 1975

Acute Cerebellar Infarction in the PICA Territory

Author Affiliations

From the Department of Neurology, Massachusetts General Hospital; Harvard Medical School; and the Massachusetts Eye and Ear Infirmary, Boston, and the Arteriosclerosis Center,; Massachusetts Institute of Technology, Cambridge, Mass.

Arch Neurol. 1975;32(6):364-368. doi:10.1001/archneur.1975.00490480030002

Although old or recent infarcts of a cerebellar hemisphere in the territories of the posterior inferior (PICA), superior, or anterior inferior cerebellar arteries are commonplace autopsy findings, in no case have corresponding clinical symptoms been clearly identified. We have studied three cases, two clinicopathologically and one clinicosurgically, in which an acute infarct involving only the cerebellum lay in the PICA territory distal to the branches to the medulla oblongata. The clinical manifestations consisted of rotatory dizziness intensified by motion, nausea, vomiting, imbalance, and nystagmus.

In two cases, the clinical diagnosis had been a benign labyrinthine disorder. Recognition of a syndrome corresponding to cerebellar infarction in the PICA territory is important insofar as it assists in the differential diagnosis of dizziness. It becomes of crucial importance when cerebellar infarction is the prelude to cerebellar swelling and brain stem compression leading to coma and death unless surgically relieved.

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