Posterior inferior cerebellar artery (PICA)

Slides:



Advertisements
Similar presentations
INTRODUCTION TO NEURO MR
Advertisements

67 yo Male  Clinical History: Presented to ED with left facial droop and left sided weakness Presented to ED with left facial droop and left sided weakness.
Neuroradiology DR. Sharifa AL-Duraibi.
Fig A midline Post-contrast Sagittal T1 Weighted MRI
Clinical assessment Aims (1) Is it a stroke? (2) What part of the brain is affected? (3) What caused this stroke? Is it a haemorrhage or an infarct? Can.
 A focal (or sometimes global) neurological defecit of sudden onset and lasting> 24h (or leading to death), and of presumed vascular origin  5-10 per.
Click to Play! Neuro Quiz  Michael McKeough 2008 Identify the correct question The Cerebrovascular System II.
Luis Rafael Moscote-Salazar. MD Kalil Kafury-Bennedeti. MD Rubén Sabogal-Barrios. MD The third annual International Neurosurgery Conference UNIVERSIDAD.
The if I Only Had a Brain… Will Kleinelp Associate professor Department of Biology.
STROKE. Stroke Classification Risk Factors Signs and Symptoms Management –Prehospital –In-hospital.
Lateropulsion Lateropulsion (deviation) of the eyes towards the side of the lesion, under closed lids.
Introduction to MRI Head Imaging
Lecturer name: Dr. fahad albadr
Consultant Neuroradiologist
2015 Joint Congress on Medical Imaging and Radiation Sciences Imaging and Intervention in Acute Stroke: MR Imaging in Acute Stroke Viesha Ciura, MD, FRCPC.
Vascular Supply to the Nervous System. Introduction Blood supplies brain cells with essential nutrients such as glucose and oxygen, and removes CO 2 from.
Dr Mohamed el Safwany, MD.
Stroke syndromes of posterior circulations
Basilar Artery Anterior inferior cerebellar artery Superior cerebellar artery Posterior cerebral artery –Posterior choroidal arteries Blood supply to.
Posterior Cerebral Artery Symptoms and signs: Postcommunal PCA –Ventrolateral thalamus sensory symptoms, usually paresthesias Motor symptoms include mild.
Vertebral artery: subject to trauma and spondylotic compression. End distribution is that of the PICA Lateral medullary syndrome / Wallenberg.
Neuroimaging in Neuropsychiatry
Brain anatomy: Cerebellum
Anatomy for Neuroimaging
STROKE Jeanette. J. Norden, Ph.D. Professor Emerita Vanderbilt University School of Medicine.
Susceptibility Weighted MRI and Cerebrovascular Disorders Fony Y Tsai, Hung-Wen Kao, Yu-Kun Tsui, Anton H Hasso and Fred Greensite, UC Irvine Medical Center,
Cerebrovascular disease Dr.Nathasha Luke Epidemiology 3rd leading cause of death and disability in the world 3rd leading cause of death and disability.
Núria Bargalló, Teresa Lema,Mar Carreño, Antonio Donaire, Javier Aparicio, Iratxe Maestro. Hospital Clínic i Provincial de Barcelona MRI Changes In Status.
Differential diagnosis for PICA
Basilar Artery Thrombosis
The brain (in most cases) comprises 2% of the entire body weight The brain utilizes 20% of the body’s oxygen 17% of the cardiac output goes to the brain.
Date of download: 6/25/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Stroke or Transient Ischemic Attacks With Basilar.
Date of download: 7/6/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Diffusion-Weighted Imaging and National Institutes.
Introduction to Neuroanatomy and Terminology. Main Regions of the Nervous System Two Main Divisions –Central Nervous System –Peripheral Nervous System.
Date of download: 9/18/2016 Copyright © The American College of Cardiology. All rights reserved. From: Embolic Cerebral Insults After Transapical Aortic.
Radiological imaging of cerebral venous thrombosis.
Fig. 2. Imaging findings of the lesion on brain MRI
Mid and lower cervical spine fractures. (A–C) Cervical burst fracture
Neuroradiology of Stroke and Headaches
Imaging Anatomy of the CNS
Brainstem & Cerebellum
Femke Maingay-de Groof, Maarten H. Lequin, Daniella W
Vanderbilt University School of Medicine
Pasquale F. Finelli, MD  Journal of Stroke and Cerebrovascular Diseases 
POSTERIOR FOSSA STROKE vascular syndromes with MRI correlation
Perinatal arterial ischemic stroke related to carotid artery occlusion
Evidence-Base Medicine
Bickley S, Stalcup S, Turan T, LeMatty T, Spampinato MV
Done By: Dr. Faisal Al-Thekair
Neuroradiology interactive lecture
Neuroradiology interactive lecture
A Case of Recurrent Ischemic Stroke due to Paradoxical Embolism through Different Channels Dong-geun Lee, M.D., Seungyoo Kim, M.D., Jae Young An, M.D.,
Endovascular treatment of acute ischemic stroke
Multiparametric MRI Tissue Characterization in Clinical Stroke With Correlation to Clinical Outcome by Michael A. Jacobs, Panayiotis Mitsias, Hamid Soltanian-Zadeh,
Figure 1 Initial brain imaging (A–C) patient 1; (D–F) patient 2; (G–I) patient 3; (J–L) patient 4; and (M) patient 2. Initial brain imaging (A–C) patient.
Pathways for Neuroimaging of Childhood Stroke
How I treat and manage strokes in sickle cell disease
Endovascular repair of subclavian artery complex pseudoaneurysm and arteriovenous fistula with coils and Onyx  Nana Amiridze, MD, PhD, Yougi Trivedi,
Dr Monica Patil JR III, Dept of Radiology Guide-Dr Sagar Kadam
MRI Brain Evaluation of brain diseases Stroke
Review of diffuse cortical injury on diffusion-weighted imaging in acutely encephalopathic patients with an acronym: “CRUMPLED”  Yasemin Koksel, John.
Lecture Title: BRAIN STEM AND CEREBELLUM (CNS Block, Radiology)
Brain stem and Cerebellar Imaging
Patient 16 is a 39-year-old woman status post bowel resection and appendectomy for Crohn disease being maintained on antibiotics and steroids with baseline.
Cardioembolic stroke in the left MCA, 2 hours after onset.
Fig. 4. A 74-year-old female with right hemiplegia and aphasia, 2 hours ago. (a) DWI shows hyperintense lesion in the entire left cerebral hemisphere.
Pretreatment DWI (A–C) and ADC maps (E–G) of a comatose 45-year-old man with areactive tetraplegia. Pretreatment DWI (A–C) and ADC maps (E–G) of a comatose.
A 61-year-old man presenting with an acute right Wallenberg syndrome.
Figure 1 Axial FLAIR brain MRI obtained on admission to the ICU demonstrated (A1) old hyperintense subcortical lesions (arrowhead), new superimposed on.
Presentation transcript:

www.afrad.org Case presentation Posterior inferior cerebellar artery (PICA) Territory acute ischemic infarct Hidayatullah Hamidi, Radiology department, FMIC 01/03/2016 www.afrad.org

Demographics and clinical problem 56 years old female presented with vertigo, nausea, vomiting and headache for last 3 days.

TECHNIQUE Brain MRI before and after IV administration of gadolinium.

T2WI

T2 FlAIR

DWI

ADC

Sagittal MO

FINDINGS: Abnormal T2WI and FLAIR hyper intense and T1WI hypointenses focal areas involving left PICA territory (postero inferior aspect of left cerrebelar hemisphere, left inferior cerebellar vermis and left side of medulla oblongata) Diffusion restriction: Increased signal in DWI and drop of signal in ADC map No post contrast enhancement

TOF MRA

Vertebral a.

Time of flight MRA Non visualization of left vertebral artery, left anterior spinal artery and left PICA representing complete obstruction/thrombosis.

CONCLUSION: Non visualization of left vertebral artery, left anterior spinal artery and left PICA representing complete thrombosis resulting in acute ischemic infarction at the left PICA territory

Discussion

PICA occlusion May cause infarction of Posterior inferior cerebellum Inferior cerebellar vermis Lateral medulla http://radiopaedia.org/articles/posterior-inferior-cerebellar-arterial-infarction-1

Epidemiology Typically considered the most common territory involved in cerebellar infarction http://radiopaedia.org/articles/posterior-inferior-cerebellar-arterial-infarction-1

Clinical presentation Most common: Vertigo, nausea and truncal ataxia. Signs of a lateral medullary syndrome (Wallenberg syndrome) may coexist in ~30%. WS: Acute ischemic infarct due to occlusion of vessels supplying lateral medulla oblongata (intracranial portion of  vertebral a. followed by PICA) Characterized by: vertigo, falling towards side of lesion, diplopia… http://radiopaedia.org/articles/posterior-inferior-cerebellar-arterial-infarction-1

PICA territory Inferior occipital surface of cerebellum. http://www.radiologyassistant.nl/en/p484b8328cb6b2/brain-ischemia-vascular-territories.html

PICA territory http://radiopaedia.org/cases/cerebral-vascular-territories

http://www. slideshare http://www.slideshare.net/arifkhansn/brain-vascular-anatomy-with-mra-and-mri-correlation

http://www. slideshare http://www.slideshare.net/arifkhansn/brain-vascular-anatomy-with-mra-and-mri-correlation

http://www. slideshare http://www.slideshare.net/arifkhansn/brain-vascular-anatomy-with-mra-and-mri-correlation

http://www. slideshare http://www.slideshare.net/arifkhansn/brain-vascular-anatomy-with-mra-and-mri-correlation

For more PowerPoint shows Visit Thank you For more PowerPoint shows Visit www.afrad.org

Feedback: Privacy Policy Feedback
Do Not Sell My Personal Information
About project: SlidePlayer Terms of Service

© 2024 SlidePlayer.com Inc. All rights reserved.