![]() ![]() The hemodynamic compromise observed in our patient with RVAS indicates that isolated vertigo and nystagmus may occur due to transient ischemia of the inferior cerebellum or lateral medulla. Lateral medullary syndrome (LMS), also known as Wallenberg syndrome, was initially recognized and documented in 1961 1. In contrast, the blood flow through the left vertebral and basilar arteries remained intact while turning the head to either side. It is usually unilateral, as the origin of PICA arises from a single. ![]() We aimed to investigate the clinical significance of this cerebrovascular variant. Strokes in the distribution of the posterior inferior cerebellar artery (PICA) are rare. This is most commonly due to occlusion of the intracranial portion of the vertebral artery followed by PICA and its branches 1-3. Lateral medullary syndrome, also known as Wallenberg syndrome, is a clinical syndrome caused by an acute ischaemic infarct of the lateral medulla oblongata. Cerebral angiography revealed a complete occlusion of the right distal VA at the level of the C1-2 junction when the head was rotated to a leftward position. A vertebral artery (VA) terminating in a posterior inferior cerebellar artery (PICA) is often considered to be a normal variation associated with VA hypoplasia. Citation, DOI, disclosures and article data. PICA supplies the lateral medulla, the inferior cerebellum, and the inferior. 2).18 The PICAs arose from the VAs after the. The blood supply of the cerebellum consists of the posterior inferior cerebellar arteries (PICAs), branches of the vertebral artery, and the anterior inferior cerebellar arteries (AICAs) and the superior cerebellar arteries (SCAs), which arise from the basilar artery. The basilar artery received its flow from the left VA only and branched out both anterior inferior cerebellar arteries. The PICA, defined as the cerebellar artery arising from the VA, was present bilaterally in this specimen (Fig. Cerebral angiography showed hypoplastic right VA terminating in PICA without connection to the basilar artery. A 59-year-old man suffered from vertigo and nystagmus induced by leftward head rotation and oculography showed right beating horizontal-torsional and downbeat nystagmus. The PICA is a paired artery that originates from the vertebral artery V4 segment. We report on a patient who developed atypical RVAS due to compression of the vertebral artery (VA) terminating in the posterior inferior cerebellar artery (PICA). Rotational vertebral artery syndrome (RVAS) is characterized by recurrent attacks of paroxysmal vertigo, nystagmus, and ataxia induced by head rotation. ![]()
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