Posterior circulation infarction

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Sudden onset gait unsteadiness, nausea and vomiting.

Patient Data

Age: 55 years
Gender: Male

Areas of high signal on T2 and FLAIR with restricted diffusion involving mainly the posterior inferior aspect of both cerebellar hemispheres more on the left as well as the cerebellar tonsils and right middle cerebellar peduncle. No evidence of arterial occlusion on the MRA 3D-TOF.

Cerebral volume loss with chronic small vessel ischemia (Fazekas 3).

Case Discussion

MRI features of posterior circulation infarction involving mainly the PICA territories.

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