Presentation
Acute vertigo, nausea, and vomiting.
Patient Data
A large area of low signal on T1WI, high signal on T2WI/FLAIR with restricted diffusion involving the posterior inferior aspect of the right cerebellar hemisphere, lateral medulla oblongata, and the ipsilateral cerebellar tonsil in keeping with an infarct in the posterior inferior cerebellar artery territory (PICA). Mass effect is noted on the 4th ventricle which is laminated and displaced to the left.
Another similar area with restricted diffusion is noted on the left side of the splenium in keeping with an infarct in the posterior pericallosal artery territory.
Prominent cerebral sulci with moderate dilatation of the ventricular system (3rd and lateral ventricles. Subcortical and periventricular hyperintense lesions visible on FLAIR and T2WI (small vessel chronic ischemia)
Case Discussion
MRI features of posterior circulation infarction affecting the right posterior inferior cerebellar artery (PICA) territory and posterior pericallosal artery territory (branch of the ipsilateral posterior cerebral artery (P3).
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