PICA infarct with hydrocephalus
Incoordination and unsteadiness for 48 hours. Now drowsy.
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A large established infarct involves the left cerebellar hemisphere in the PICA territory. There is significant mass effect with effacement of the fourth ventricle and resultant hydrocephalus.
A large acute PICA territory infarct resulted in hydrocephalus. The patient went on to have a decompressive craniectomy and resection of the infarct to alleviate compression.