Huang XM, Liao YQ, Cao LM. Massive cerebellar infarction caused by spontaneously isolated posterior inferior cerebellar artery dissection: A case report. World J Clin Cases 2025; 13(21): 103105 [DOI: 10.12998/wjcc.v13.i21.103105]
Corresponding Author of This Article
Li-Ming Cao, MD, PhD, Professor, Department of Neurology, The First Affiliated Hospital of Shenzhen University, No. 3002 Sungang Road, Shenzhen 518000, Guangdong Province, China. caoliming@szseyy.com
Research Domain of This Article
Neuroimaging
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jul 26, 2025; 13(21): 103105 Published online Jul 26, 2025. doi: 10.12998/wjcc.v13.i21.103105
Massive cerebellar infarction caused by spontaneously isolated posterior inferior cerebellar artery dissection: A case report
Xu-Ming Huang, Yu-Qi Liao, Li-Ming Cao
Xu-Ming Huang, Department of Gastroenterology, Shenzhen Baoan Shiyan People’s Hospital, Shenzhen 518108, Guangdong Province, China
Yu-Qi Liao, Li-Ming Cao, Department of Neurology, The First Affiliated Hospital of Shenzhen University, Shenzhen 518000, Guangdong Province, China
Li-Ming Cao, Hunan Provincial Key Laboratory of The Research and Development of Novel Pharmaceutical Preparations, Changsha Medical University, Changsha 410219, Hunan Province, China
Co-first authors: Xu-Ming Huang and Yu-Qi Liao.
Author contributions: Cao LM conceived of and designed the study, reviewed the manuscript and acquired funding for this study; Huang XM, Liao YQ wrote the original draft; Huang XM, Liao YQ contributed equally to this work and share first authorship. All authors have read and approved the manuscript.
Supported by Shenzhen Second People’s Hospital Clinical Research Fund of Shenzhen High-level Hospital Construction Project, No. 20243357001.
Informed consent statement: The participant provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors confirm that they have no competing interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-Ming Cao, MD, PhD, Professor, Department of Neurology, The First Affiliated Hospital of Shenzhen University, No. 3002 Sungang Road, Shenzhen 518000, Guangdong Province, China. caoliming@szseyy.com
Received: November 13, 2024 Revised: March 12, 2025 Accepted: April 9, 2025 Published online: July 26, 2025 Processing time: 169 Days and 17.1 Hours
Abstract
BACKGROUND
Diagnosing posterior inferior cerebellar artery dissection (PICAD) using radiological images is challenging. Massive cerebellar infarctions resulting from spontaneous, isolated PICAD are rare, and the associated clinical, imaging, and treatment options remain unclear.
CASE SUMMARY
A 39-year-old man was admitted for dizziness and unstable gait for two days. Physical examination revealed decreased right-limb muscle strength and right-sided ataxia. Brain magnetic resonance imaging (MRI) showed a massive acute right cerebellar infarction, but other modalities, including head and neck computed tomographic angiography (CTA) and magnetic resonance angiography (MRA), showed no obvious abnormalities. High-resolution vessel wall MRI (HR-VW-MRI) revealed right PICAD. The patient was diagnosed with massive cerebellar infarction caused by PICAD and active conservative treatment was initiated. The initial PICAD lesion disappeared 1.5 months after discharge, after which the patient experienced only slight weakness in his right limb for three months.
CONCLUSION
Since MRA and CTA may fail to identify PICAD, HR-VW-MRI is key in diagnosis and follow-up evaluation. Aggressive medication may be effective and safe for treating PICAD.
Core Tip: Diagnosis of posterior inferior cerebellar artery dissection (PICAD) can be challenging with conventional imaging methods like magnetic resonance angiography or computed tomographic angiography. High-resolution vessel wall magnetic resonance imaging is crucial for accurate diagnosis and follow-up. Aggressive conservative treatment may be effective and safe for managing PICAD, with significant recovery observed in the patient within 3 months.
