Brain Stem and Cerebellar Infarcts

Cerebellar infarction is caused by occlusion of one of the major posterior circulation branches, which include the superior cerebellar, the anterior and posterior inferior cerebellar arteries, and the basilar artery. The posterior inferior cerebellar artery (PICA) supplies the postero-inferior portions of the cerebellum and is the most commonly obstructed cerebellar artery. The size of the infarct is important because a large infarct may cause a significant mass effect on the fourth ventricle and lead to hydrocephalus as well as brain stem compression. PICA infarctions can also result in the so-called lateral medullary (Wallenberg) syndrome, manifested by ipsilateral Horner's syndrome, ataxia, dysphagia, vertigo, nystagmus, hiccups and contralateral numbness, diminished pain and temperature sensation. The brain stem and cerebellar infarcts behave similar to cerebral infarcts on DW imaging and ADC maps (Fig. 5.9).

Figure 5.9 a-c

Brain stem infarction in an 83-year-old woman with slurred speech and gait difficulties. a T2-weighted image show hyperintense lesions in the pons (arrows). b DW image clearly shows a hyperintense lesion.c ADC is decreased in the right side of the pons, representing acute infarction (arrow)

Figure 5.9 a-c

Brain stem infarction in an 83-year-old woman with slurred speech and gait difficulties. a T2-weighted image show hyperintense lesions in the pons (arrows). b DW image clearly shows a hyperintense lesion.c ADC is decreased in the right side of the pons, representing acute infarction (arrow)

Brain Stem

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Responses

  • camelia
    Can cerebral edema cause lateral medullary infarct?
    7 years ago

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