ISSN 1004-4140
CN 11-3017/P
SUN R J, ZHANG S Y, CHENG X, et al. Imaging features and etiology of acute cerebral infarction in bilateral PICA territory[J]. CT Theory and Applications, 2022, 31(3): 337-344. DOI: 10.15953/j.ctta.2022.060. (in Chinese).
Citation: SUN R J, ZHANG S Y, CHENG X, et al. Imaging features and etiology of acute cerebral infarction in bilateral PICA territory[J]. CT Theory and Applications, 2022, 31(3): 337-344. DOI: 10.15953/j.ctta.2022.060. (in Chinese).

Imaging Features and Etiology of Acute Cerebral Infarction in Bilateral PICA Territory

More Information
  • Received Date: April 10, 2022
  • Revised Date: April 24, 2022
  • Accepted Date: April 24, 2022
  • Available Online: April 27, 2022
  • Published Date: May 22, 2022
  • Objective: To investigate the MRI features and etiology of acute cerebral infarction in bilateral PICA territory. Methods: 38 patients with bilateral PICA and 40 patients with bilateral SCA diagnosed clinically and radiographically in Beijing Friendship Hospital of Capital Medical University from January 2019 to January 2022, were retrospectively analyzed. The difference of MRI features, were compared between the two groups, according to the size of the infarction, the distribution of infarcted lesions in posterior circulation or anterior circulation. The range of acute infarction in the bilateral PICA territory and the changes of vertebrobasilar artery were analyzed. Results: The proportion of the infarction model of one side regional infarction with the other side small infarct in bilateral PICA was significantly higher than that in bilateral SCA (39.5% vs. 15%), while the model of small infarction on both sides was lower than that in bilateral SCA (44.7% vs. 72.5%). The incidence of infarction in other blood supply areas of the combined posterior circulation was significantly lower than that in bilateral SCA (21% vs. 80%). The infarction models of bilateral PICA manifested as unilateral total infarct of PICA territory combined with the other unilateral infarct of mPICA territory (44.7%) or bilateral mPICA territory (39.5%). Unilateral vertebral artery V4 segment or PICA-localized severe stenosis/occlusion were more frequently detected in acute infarcts in bilateral PICA (54.2%). Conclusions: Bilateral PICA territory infarction mainly manifested as unilateral total infarct of PICA territory combined with the other unilateral or bilateral infarct of mPICA territory, and regional infarction was quite common, which was closely related to anatomical variation.
  • [1]
    DZIADKOWIAK E, CHOJDAK-ŁUKASIEWICZ J, GUZIŃSKI M, et al. The usefulness of the toast classification and prognostic significance of pyramidal symptoms during the acute phase of cerebellar ischemic stroke[J]. Cerebellum, 2015, 15(2): 159−164.
    [2]
    De COCKER L J, LÖVBLAD K O, HENDRIKSE J. MRI of Cerebellar Infarction[J]. European Neurology, 2017, 77(3/4): 137−146.
    [3]
    WANG P Q, DING Z G, ZHANG G B, et al. A study on lesion pattern of bilateral cerebellar infarct[J]. European Review for Medical and pharmacological Sciences, 2015, 19(10): 1845−1851.
    [4]
    张伟晴, 蔡俊秀, 樊露, 等. 双侧小脑急性梗死模式观察与分析[J]. 中华老年心脑血管病杂志, 2019,21(4): 403−406. DOI: 10.3969/j.issn.1009-0126.2019.04.017.

    ZHANG W Q, CAI J X, FAN L, et al. Analysis of acute bilateral cerebellar infarction patterns[J]. Chinese Journal of Geriatric Heart Brain and Vessel Diseases, 2019, 21(4): 403−406. DOI: 10.3969/j.issn.1009-0126.2019.04.017. (in Chinese).
    [5]
    AMARENCO P, LÉVY C, COHEN A, et al. Causes and mechanisms of territorial and nonterritorial cerebellar infarcts in 115 consecutive patients[J]. Stroke, 1994, 25(1): 105−112. doi: 10.1161/01.STR.25.1.105
    [6]
    HONG J M, BANG O Y, CHUNG C S, et al. Frequency and clinical significance of acute bilateral cerebellar infarcts[J]. Cerebrovascular Diseases, 2008, 26(5): 541−548. doi: 10.1159/000160211
    [7]
    PETTY G W, BROWN R D, WHISNANT J P, et al. Ischemic stroke subtypes: A population-based study of functional outcome, survival, and recurrence[J]. Stroke, 2000, 31(5): 1062−1068. DOI: 10.1161/01.STR.31.5.1062.
    [8]
    BOUKOBZA M, LAISSY J P. Unusual pattern of bilateral cerebellar infarct and bihemispheric posterior-inferior cerebellar artery[J]. Journal of Neurology, Neurosurgery and Psychiatry, 2021, 17: 433−436.
    [9]
    HAN S W, CHO G C, BAIK J S, et al. Bilateral cerebellar infarction caused by dominant medial posterior inferior cerebellar artery[J]. Neurology, 2006, 66(7): 1125−1126. doi: 10.1212/01.wnl.0000204293.27365.ec
    [10]
    MARINKOVIĆ S, KOVACEVIĆ M, GIBO H, et al. The anatomical basis for the cerebellar infarcts[J]. Surgical Neurology, 1995, 44(5): 460−461.
    [11]
    李雯雯, 孙启英, 易芳, 等. 小脑后下动脉解剖变异致双侧小脑梗死2例报道并文献复习[J]. 卒中与神经疾病, 2017,24(4): 302−305. DOI: 10.3969/j.issn.1007-0478.2017.04.006.

    LI W W, SUN Q Y, YI F, et al. Clinical analysis of bilateral cerebellar infarction caused by anatomic variations of the posterior inferior cerebellar artery in two patients and literature review[J]. Stroke and Nervous Diseases, 2017, 24(4): 302−305. DOI: 10.3969/j.issn.1007-0478.2017.04.006. (in Chinese).
    [12]
    程敏, 李浩然, 朱洋洋, 等. 小脑后下动脉少见变异导致的双侧小脑半球梗死1例报告[J]. 中风与神经疾病杂志, 2015,32(6): 556−557.
    [13]
    FUJIMOTO M, SALAMON N, MAYOR F, et al. Characterization of arterial thrombus compostion by magnetic resonance imaging in a swine stroke model[J]. Stroke, 2013, 44(5): 1463. doi: 10.1161/STROKEAHA.111.000457

Catalog

    Article views (287) PDF downloads (21) Cited by()
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return