A case of secondary cerebellar infarction due to bilateral posterior inferior cerebellar artery dissection during conservative treatment

Abstract

A 42-year-old man suffering from hypertension was admitted to our hospital following a sudden onset of headache, dizziness, and vomiting. Magnetic resonance imaging (MRI) procedure was performed, revealing an infarction of the left cerebellar hemisphere. There was no apparent sign of dissection. Antithrombotic treatment was started and monitored carefully. On day 9, the patient complained of dysphagia, and an ensuing MRI showed a new right cerebellar hemisphere infarction. MRA and conventional angiography were conducted, revealing dissection of the bilateral posterior inferior cerebellar arteries (PICAs). We proceeded with conservative treatment and there was no recurrence of stroke. In this case, an infarction of the right cerebellar hemisphere appeared in the acute phase of an infarction of the left cerebellar hemisphere due to bilateral PICA dissection. Bilateral PICA dissection is quite rare, and we have not found such a case in the literature.