Case Report: What is Your Differential Diagnosis for Bilateral Cerebellar Infarct?

Q4 Medicine
Connecticut Medicine Pub Date : 2016-09-01
Aaron Snyder, Tina Chen, Kalilah Hunter-Anderson, Douglas Fellows
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引用次数: 0

Abstract

Neurovascular variants are not frequently described outside of specialty literature. Infarction involving these atypical neurovascular structures present with unusual clinical findings and radiologic imaging. A 63-year-old man with hypertension, diabetes, and former tobacco use presented from the Department of Corrections with global headache, nausea, vomiting, and double vision. He was found to be hypertensive to 240/120. CT imaging noted acute ischemic changes in the bilateral posterior inferior cerebellar artery distribution. Follow up 3-D time-of-flight (TOF) magnetic resonance angiography (MRA) of the cranial region demonstrated abrupt cut off of an azygous right posterior inferior cerebellar artery (PICA) and presumed absence of the left PICA. The patient underwent occipital craniotomy for evolving ischemic stroke and development of hydrocephalus, and ultimately recovered without neurologic deficits.

病例报告:双侧小脑梗死的鉴别诊断是什么?
神经血管变异在专业文献之外不常被描述。涉及这些非典型神经血管结构的梗死表现为不寻常的临床表现和放射影像。一名患有高血压、糖尿病和有吸烟史的63岁男性从矫正部就诊,伴有全身头痛、恶心、呕吐和复视。他被发现高血压至240/120。CT显示双侧小脑后下动脉分布出现急性缺血性改变。后续3-D飞行时间(TOF)磁共振血管造影(MRA)显示右侧小脑后下动脉(PICA)突发性切断,推测左侧PICA缺失。由于缺血性脑卒中的发展和脑积水的发展,患者接受了枕骨开颅手术,最终康复,无神经功能障碍。
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来源期刊
Connecticut Medicine
Connecticut Medicine Medicine-Medicine (all)
自引率
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期刊介绍: The Connecticut State Medical Society (CSMS) is a federation of eight component county medical associations, with a total membership exceeding 7,000 physicians. CSMS itself is a constituent state entity of the American Medical Association. Founded by the physician-patriots of the American Revolution, the Society operates from a heritage of democratic principles embodied in its Charter and Bylaws. The base of all authority in CSMS is, of course, the individual physician member. It is the decisions of members in their own county associations that ultimately determine the nature of the Society"s policies and activities.
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