Presentation
Truncal ataxia with vertigo.
Patient Data
Large area of low signal on T1, high signal on T2 and FLAIR with restricted diffusion involving the right inferior posterior aspect of the cerebellum and the ipsilateral cerebellar tonsil (PICA territory) with no haemorrhagic component seen on GE sequence.
The MRA (3D-TOF) shows a hypoplastic right vertebral artery with no visualisation of the posterior inferior cerebellar artery (PICA) compared to the left side.
Cerebral volume loss with small vessel ischaemic disease.
Case Discussion
MRI features of acute PICA territory infarct which is considered the most common territory involved in cerebellar infarction.