Posterior inferior cerebellar artery (PICA) infarct

Case contributed by Dr Matt Adams


Headache, nystagmus, impaired coordination and vomiting.

Patient Data

Age: 80
Gender: Male

CT non-contrast

CT non-contrast with stroke windowing (WW 40, WL 40) shows a subtle loss of grey white differentiation of the inferior cerebellar vermis and posterior inferior cerebellum. There is a small punctate hyperdensity along the course of the left PICA.

The left PICA loses contrast enhancement shortly after its origin. No distal branch enhancement. There is normal enhancement of the right PICA branches.


There is increased MTT at the left inferior cerebellum with corresponding less confluent decrease of CBV. indicating core infarct with small penumbra.

Case Discussion

This study shows the importance of checking every slice for abnormality as seen by the PICA infarct in the lowest slices.

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Case information

rID: 63382
Published: 30th Sep 2018
Last edited: 1st Oct 2018
Inclusion in quiz mode: Included

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