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Cerebellar PICA Infarction

Sloan DMS - MedPix (2007)

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Cerebellar PICA Infarction

History: 47 yo man with 6 month Hx of headaches - now reports experiencing “worst headache of his life” accompanied by nausea, vomiting, and dizziness. Pt notes waking up with a mild headache on the day of admission, unrelieved by caffeine consumption, that progressively worsened. The pain was sharp, but throbbing and located behind his left eye and radiating posteriorly.

Findings: •CT on HD#1 demonstrated no evidence of infarction, inflammation, or bleeding. •CT on HD#3 showed a change in density in areas of the left cerebellum •MRI/MRA of the head and brain on HD#4 demonstrated subacute L PICA territory infarcts and normal intracranial MRA. •MRI/MRA of the neck on HD#5 demonstrated no dissection, aneurysm or focal stenosis of the vertebral arteries.

Ddx: • Cerebellar embolic Infarction • Vertebral artery dissection

Dxhow: Confirmed by MRI with matching DWI and ADC abnormalities.

Exam: Initial vital signs demonstrated afebrile pt with BP 159/77, HR 82, RR 22. Initial exam wnl, including neurologic exam. HD#5, mild gait disturbance noted with deviation to the left, and deficits in high level and dynamic gait activity. Labs: SPEP, Protein C, Protein S, Antithrombin III, Hypercoag panel, ANA, ENA, RF, B12, Folate, MMA, CoagII, ESR, CRP, Homocysteine, cardiolipin panel, RPR, Lipid panel all wnl. An LP was performed and wnl. TTE and TEE both showed no abnormalities or clots.

No MeSH data available.


Normal CT taken hours after presentation.
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MPX2388_synpic34942: Normal CT taken hours after presentation.


Cerebellar PICA Infarction

Sloan DMS - MedPix (2007)

Normal CT taken hours after presentation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX2388&req=5

MPX2388_synpic34942: Normal CT taken hours after presentation.

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Cerebellar PICA Infarction

History: 47 yo man with 6 month Hx of headaches - now reports experiencing “worst headache of his life” accompanied by nausea, vomiting, and dizziness. Pt notes waking up with a mild headache on the day of admission, unrelieved by caffeine consumption, that progressively worsened. The pain was sharp, but throbbing and located behind his left eye and radiating posteriorly.

Findings: •CT on HD#1 demonstrated no evidence of infarction, inflammation, or bleeding. •CT on HD#3 showed a change in density in areas of the left cerebellum •MRI/MRA of the head and brain on HD#4 demonstrated subacute L PICA territory infarcts and normal intracranial MRA. •MRI/MRA of the neck on HD#5 demonstrated no dissection, aneurysm or focal stenosis of the vertebral arteries.

Ddx: • Cerebellar embolic Infarction • Vertebral artery dissection

Dxhow: Confirmed by MRI with matching DWI and ADC abnormalities.

Exam: Initial vital signs demonstrated afebrile pt with BP 159/77, HR 82, RR 22. Initial exam wnl, including neurologic exam. HD#5, mild gait disturbance noted with deviation to the left, and deficits in high level and dynamic gait activity. Labs: SPEP, Protein C, Protein S, Antithrombin III, Hypercoag panel, ANA, ENA, RF, B12, Folate, MMA, CoagII, ESR, CRP, Homocysteine, cardiolipin panel, RPR, Lipid panel all wnl. An LP was performed and wnl. TTE and TEE both showed no abnormalities or clots.

No MeSH data available.