Acute bilateral cerebellar infarction in territory of the posterior inferior cerebellar artery: a case report

Abstract

Background: Cerebellar infarcts are a rare entity with a low incidence of all ischemic strokes. The most prevalent territory of cerebellar infarcts are those of the inferior posterior cerebellar artery (PICA). When infarcts are confined to the cerebellum, patients typically experience nonspecific symptoms, leading to misdiagnosis of other diagnoses. Description of the clinical case: 54-year-old female patient, with a history of arterial hypertension, who presented insidious and progressive headache accompanied by vertigo, impaired gait and progressive deterioration of consciousness. Brain magnetic resonance imaging (MRI) was performed, which revealed bilateral hyperintense areas in the cerebellar region that delimit the vascular territory of the Inferior posterior cerebellar artery, as well as moderate dilation of the ventricular system. She underwent surgery, performing a decompressive suboccipital craniectomy; after surgery with clinical improvement. Conclusions: Bilateral cerebellar ischemic stroke is a rare form of stroke and its clinical presentation is very diverse. The development of neuroimaging plays an important role in helping physicians select the appropriate treatment. Approximately half of the patients with cerebellar infarcts who present with progressive neurological deterioration and are treated with decompressive suboccipital craniectomy have good results. The fundamental pillar of this case was to make an early diagnosis of this entity, since it allowed to identify the possible serious complications associated with cerebellar infarction, which occur during the first week of the stroke, and therefore to ensure a favorable prognosis for the patient.