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.
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).
Footnotes
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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.
Series editor: Mitchell S.V. Elkind MD, MS, Section Editor
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