Five cases with isolated dissection of the posterior inferior cerebellar artery: diagnosis, clinical characteristics and outcome

• Published in: Japanese Journal of Stroke Vol. 43; no. 2; pp. 109 - 116
• Main Authors: Nishitani, Kazutoshi, Hiramitsu, Hiroyuki, Miura, Keisuke, Okada, Yoshifumi, Hayashi, Yoshifumi, Yoshida, Hirotaka
• Format: Journal Article
• Language: Japanese
• Published: The Japan Stroke Society 2021
• Subjects: cerebral infarction; isolated dissection of the posterior inferior cerebellar artery; subarachnoid hemorrhage; surgical treatment
• ISSN: 0912-0726; 1883-1923
• DOI: 10.3995/jstroke.10797

Background and Purpose: Isolated dissection of the posterior inferior cerebellar artery (IDPICA) is very rare. We have experienced five cases with IDPICA for seven years. The purpose of this study is to investigate the clinical manifestations, the radiological features, the surgical treatment and outcome of the cases with IDPICA. Method: Five patients with IDPICA admitted in our hospital from April, 2011 to March, 2018. We examined the clinical manifestations, the radiological findings, the surgical treatment for IDPICA and outcome at discharge. Results: All five patients are male (39–62 years old, mean 50.8 years old), three of five patients presented severe headache caused by SAH, two of five patients presented neck pain and dizziness caused by dissection and cerebellar infarction. MRA was performed on all patients at first visit to our hospital and Institutions. MRA of SAH patients revealed the irregular aneurysmal dilatation of posterior inferior cerebellar artery (PICA), of Ischemic patients revealed pearl and string sign of PICA. Surgical treatment was carried out in three cases. Two cases undergone a suboccipital craniectomy and trapping of PICA, one case undergone a trapping of PICA with OA-PICA anastomosis. The outcome at discharge were followed, a good recovery (modified Rankin scale 0–1) were three patients, moderate disability (m-RS 4) were two patients and the mortality rate is zero. Conclusion: It is considered that MRA is useful for the diagnosis of IDPICA. We consider that the outcome of IDPICA is relatively good, if accurate diagnosis and appropriate treatment was provided to patients with IDPICA.