Anterior inferior cerebellar artery (AICA) infarct

Last revised by Rohit Sharma on 6 Mar 2024

Anterior inferior cerebellar artery (AICA) territory infarcts are much less common than posterior inferior cerebellar artery (PICA) infarcts. AICA generally arises from the caudal third of the basilar artery and supplies the lateral pons, inner ear, middle cerebellar peduncle and the anterior inferior cerebellum 4,5.

AICA territory infarcts are rare, comprising ~1% of ischemic cerebellar strokes 2

Vertigo (can be central or peripheral due to the arterial supply) is the most common symptom associated with an AICA infarct, however, it is normally associated with neurological signs and symptoms such as facial weakness, hypoacusis, facial sensory loss, crossed sensory loss, gait ataxia, limb ataxia and Horner syndrome 4-6. In AICA syndrome, the neurological symptoms described above are the symptoms often seen first 7.

Acute interruption of blood flow through the AICA which leads to deprivation of oxygen and glucose in the vascular territory supplied. This phenomenon triggers a cascade of events at a cellular level, that if the circulation is not restored in time, will lead to cell death.

The main cause of AICA territory stroke is atherosclerosis, but can also be a lacunar infarct due to hypertension or thromboembolism, although sometimes the cause is not known.

Generally, the features are those of brain infarction but in the anterior cerebellar artery vascular territory: middle cerebellar peduncle, inferolateral portion of the pons, flocculus, and anteroinferior surface of the cerebellum. As such these features are discussed in the generic article: cerebral infarction.

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