Anatomical hierarchy

Vasculary territories > Territory of posterior inferior cerebellar artery (PICA)

Translations

Description

It is the most variable cerebral artery and has a variable territory depending on the size of the AICA. Typically, the PICA may supply:

  • posteroinferior cerebellar hemispheres (up to the great horizontal fissure) : cerebellar tonsils, biventral lobule, nucleus gracilis, superior semilunar lobule, inferior portion of the vermis
  • lower part of the medulla

Stroke pattern:

Common type of cerebellar stroke: headache, vertigo, nystagmus, ipsilateral axial lateropulsion, gait and appendicular ataxia.

More or less complete dorsal lateral medullary syndrome (Wallenberg syndrome) if the medulla is involved: ipsilesional vestibular  (vertigo, vomiting, nystagmus, lateropulsion), V, IX and X cranial nerve palsies, Horner syndrome, appendicular ataxia with contralesional loss of pain and temperature sensation. Hiccups are frequent and prolonged.


The vascular territories in the cerebellum and brainstem: CT and MR study. by Savoiardo M, Bracchi M, Passerini A, Visciani A. AJNR Am J Neuroradiol. 1987 Mar-Apr;8(2):199-209. Oxford Textbook of Stroke and Cerebrovascular Disease - Bo Norrving - Oxford University Press, 2019

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