Posterior Cerebellar Artery Infarct

Ray Ballinger, MD, PhD

Straub Clinic and Hospital

rballinger at straub.net

Abstract

83 y/o woman arrived unresponsive after a fall.

Keywords

Brain infarct all ct MRI

History and Images

83 y/o woman with paroxysmal atrial fibrillation. Arrived unresponsive after a fall.

current CT old CT from 2 years ago
Current CT scan (left) and an old one (right) for comparison.

Findings

CT scan shows increased signal in tip of basilar artery, not seen on a prior study 2 years prior. An MRI scan was then performed (below) showing occlusion of the distal basilar artery with a large acute infarct in the distribution of the right superior cerebellar artery and a small one on the left. The posterior communicating arteries appear to reconstitute the distal tip of the basilar artery and supply the posterior cerebral arteries.

Diagnosis

Posterior Cerebellar Artery Infact from thrombosed Basilar Artery

Confirmation:

MRI and clinical findings.

Discussion

The superior cerebellar arteries supply superior aspect of the vermis and cerebellar hemispheres including most of the deep cerebellar white matter. If the entire tip of the basilar artery was occluded, we might see infarcts in the pons, midbrain, thalami and posterior cerebral artery distribution (which was not the case in this patient). The patient had chronic atrial fibrillation that may have been a source for an embolism to occlude the basilar/posterior cerebellar artery.