Anterior inferior cerebellar artery (AICA) infarct

Case contributed by Nolan Walker


Pancreatic cancer. On Apixaban. Fell from bed. In morning slumped to left side. Numbness of left side face. Voice change. No ability to cough.

Patient Data

Age: 85 years
Gender: Female

This CT study reveals a focus of low attenuation in the anteroinferior left cerebellar hemisphere. These findings are compatible with an anterior inferior cerebellar artery (AICA) infarct.

Multiple white matter hypodense patches, more in periventricular region suggestive of cerebral small vessel disease.

Case Discussion

The patient presented with classical symptoms of an AICA infarct.

AICA syndrome (or lateral pontine syndrome) symptoms include:

  • voice change with no ability to cough

  • slumped to ipsilateral side, caused by vestibular nuclei ischemia

  • left side of face numbness, as a result of damage to the main trigeminal nucleus

Other AICA syndrome symptoms include:

  • paralysis of the facial muscles, secondary to facial nucleus ischemia

  • tinnitus and or loss of hearing, secondary to cochlear nuclei ischemia

Case presented with Dr A Kerr MBChB.

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