• Journal of Korean Neurosurgical Society
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• v.54 no.3
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• pp.239-242
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• 2013

Spontaneous bilateral cerebellar infarction in the territory of the superior cerebellar arteries is extremely rare. Occasionally there have been reports of bilateral cerebellar infarction due to vertebrobasilar atherosclerotic occlusion or stenosis, whereas no report of bilateral cerebellar infarction due to complicated hemodynamic changes. In this report, we present a patient with bilateral cerebral infarctions related to stenoses of bilateral internal carotid arteries, in whom vertebrobasilar system was supplied by multiple collaterals from both posterior communicating arteries and right external carotid artery. We performed stent-angioplasty of bilateral internal cerebral arterial stenosis, and then acute infarction developed on bilateral superior cerebellar artery territories. The authors assumed that the infarction occurred due to hemodynamic change between internal carotid artery and external carotid artery after stent-angioplasty for stenosis of right internal carotid artery.

• The Journal of Internal Korean Medicine
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• v.37 no.2
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• pp.143-155
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• 2016

Objective: This study reports on three cases of cerebellar artery infarction patients treated by traditional Korean medicine.Method: Three patients with cerebellar artery infarction according to cerebellar artery were treated by traditional Korean medicine at the traditional Korean medicine hospital of Daejeon University. The posterior cerebral artery (PCA) infarction patient had ataxia, dysarthria, gait disturbance, and dizziness; the anterior inferior cerebellar artery (AICA) infarction patient had facial palsy, dizziness, and hearing loss; and the posterior inferior cerebellar artery (PICA) infarction patient had gait disturbance and dizziness. Acupuncture, herbal medicine, and pharmacopuncture were used as traditional Korean medicine treatments during hospitalization. We then observed any improvement in the symptoms.Results: The scale for the assessment and rating of ataxia (SARA) score (gait, stance) of the PCA infarction patient was reduced from 8.6 to 2.2, while the dizziness numerical rating scale (NRS) score was reduced from 10 to 2 after treatment. The Yanagihara score of the AICA infarction patient was reduced from 27 to 14, while the dizziness NRS score was reduced from 10 to 2 after treatment. The SARA score (gait, stance) of the PICA infarction patient was reduced from 7.4 to 1.0, and the dizziness NRS score was reduced from 10 to 1 after treatment.Conclusion: Traditional Korean medicine appears to be effective in treating cerebellar infarction symptoms.

• The Journal of Internal Korean Medicine
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• v.38 no.5
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• pp.709-718
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• 2017

Objective: This study is a report on a case of cerebellar infarction with vertebrobasilar artery dissection which was improved by Korean medicine. Methods: A 63-year-old man diagnosed with cerebellar infarction with vertebrobasilar artery dissection was admitted to hospital for 86 days and treated with Korean medicine (acupuncture and herbal medicine) and rehabilitation treatment. Clinical symptoms were assessed with a Modified Barthel index, functional independent measurement, Berg balance scale, manual muscle test, and a visual analogue scale. Result: After treatment, the clinical symptoms were improved, and the evaluation index scores (modified Barthel index, functional independent measurement, Berg balance scale) increased. Conclusion: Korean medicine may be a meaningful treatment for patients with cerebellar infarction with vertebrobasilar artery dissection.

• Journal of Korean Neurosurgical Society
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• v.50 no.6
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• pp.520-522
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• 2011

Injury to the vertebral artery during anterior cervical discectomy is rare but potentially fatal. We report a case of cerebellar infarction after endovascular embolization for iatrogenic vertebral artery injury at C5-C6 during an anterior cervical discectomy and fusion. A 61-year-old man had an intraoperative injury of the right vertebral artery that occurred during anterior cervical discectomy and fusion at C5-C6. Hemorrhage was not controlled successfully by packing with surgical hemostatic agents. While the patient was still intubated, an emergency angiogram was performed. The patient underwent endovascular occlusion of the right V2 segment with coils. After the procedure, his course was uneventful and he did not show any neurologic deficits. Brain computed tomographic scans taken 3 days after the operation revealed a right cerebellar infarction. Anti-coagulation medication was administered, and at 3-month follow-up examination, he had no neurologic sequelae in spite of the cerebellar infarction.

• The Journal of Internal Korean Medicine
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• v.43 no.2
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• pp.122-129
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• 2022

Objective: This study investigates the efficacy of Korean medical treatment for a patient with peripheral facial palsy caused by cerebellar artery infarction. Methods: A 45-year-old male patient with right facial palsy and left side numbness from cerebellar artery infarction was treated with herbal medicine (ligigeopoongsan), acupuncture, pharmacopuncture, and cupping therapy for 37 days. The effects were evaluated using the House-Brackmann (H-B) and Yanagihara's unweighted grading systems. Results: Following treatment, the patient's H-B grade decreased and Yanagihara score improved. Conclusion: Korean medical treatment improved peripheral facial palsy in a patient with cerebellar artery infarction.

• Journal of Korean Neurosurgical Society
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• v.41 no.3
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• pp.196-199
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• 2007

Dissecting aneurysms frequently involve the vertebral arteries and their branches, but those involving the posterior inferior cerebellar artery [PICA] and not vertebral artery at all are extremely rare. We present a case of an isolated dissecting aneurysm of the PICA without involvement of vertebral artery. A 54-year-old man presented with dizziness and headache. MR imaging of the brain showed a cerebellar infarction of the left PICA territory. MR angiographic and cerebral angiographic studies revealed a dissecting fusiform aneurysm involving the left proximal PICA. Subsequently, the patient underwent GDC embolization. A postembolization angiogram demonstrated complete obliteration of the aneurysm. In this report, the treatment modalities for this rare condition is described with review of the literature.

• Journal of Korean Neurosurgical Society
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• v.46 no.3
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• pp.221-225
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• 2009

Objective : Surgical treatment of posterior inferior cerebellar artery (PICA) aneurysms is challenging due to limited surgical accessibility. Endovascular approach has a benefit of avoiding direct injury to the brainstem or lower cranial nerves. Therefore, it has recently been considered an alternative or primary modality for PICA aneurysms. We retrospectively assessed outcomes following detachable coil embolization of saccular PICA aneurysms. Methods : From February 1997 to December 2007, we performed endovascular procedures to treat 15 patients with 15 PICA aneurysms. Fourteen patients with 14 PICA aneurysms morphology of which was saccular were reviewed retrospectively. Twelve patients had ruptured aneurysms. The aneurysms arose from the PICA origin site (n=12), the PICA lateral medullary segment (n=1), or the PICA tonsilomedullary segment (n=1). Results : Complete aneurysm occlusion was achieved in 10 patients, residual neck in 3, and residual sac in one. Radiological follow-up was performed in 7 patients with mean duration of 34.7 months (range, 1-97 months) and showed stable or complete occlusion in 6 patients. There were no rebleeding or retreatment after endovascular treatment. Thromboembolism was the only procedure-related complication (n=4 ; 28.6%). Asymptomatic PICA infarction occurred in two patients and symptomatic PICA infarction in two elderly patients with poor clinical grade. Of these procedural PICA infarction cases, 1 symptomatic PICA infarction patient developed ventriculitis and septic shock leading to death. The clinical outcome was good in 10 patients (71.4%). Conclusions : In the present study, detachable coil embolization has shown as an efficient modality for PICA saccular aneurysms challenging indications of microsurgery. However, thromboembolic complications should be considered, especially in poor clinical elderly patients with ruptured aneurysms.

• The Journal of Internal Korean Medicine
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• v.25 no.4
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• pp.200-206
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• 2004

Anterior inferior cerebellar artery(AICA) is a branch of the basilar artery which supplies the bloods for ventrolateral cerebellum and the lateral tegmentum of the lower two-thirds of pons. AICA occlusion can cause such symptoms as acute-onset unilateral deafness, vertigo, facial weakness and ataxia. A case of sudden hearing loss, facial palsy and vertigo caused by AICA territory infarction recently presented itself. Korean Oriental and Western medical therapy were applied in combination. Facial palsy and vertigo improved, but hearing loss did not improve. This case is reported with a brief overview of related literatures.

• Journal of Korean Neurosurgical Society
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• v.51 no.3
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• pp.160-163
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• 2012

We report an unusual case of lateral medullary infarction after successful embolization of the vertebral artery dissecting aneurysm (VADA). A 49-year-old man who had no noteworthy previous medical history was admitted to our hospital with a severe headache. Computed tomography (CT) revealed a subarachnoid hemorrhage, located in the basal cistern and posterior fossa. Cerebral angiography showed a VADA, that did not involve the origin of the posterior inferior cerebellar artery (PICA). We treated this aneurysm via endovascular trapping of the vertebral artery distal to the PICA. After operation, CT revealed post-hemorrhagic hydrocephalus, which we resolved with a permanent ventriculoperitoneal shunt procedure. Postoperatively, the patient experienced transient mild hoarsness and dysphagia. Magnetic resonance image (MRI) showed a small infarction in the right side of the medulla. The patient recovered well, though he still had some residual symptom of dysphagia at discharge. Such an event is uncommon but can be a major clinical concern. Further investigation to reveal risk factors and/or causative mechanisms for the medullary infarction after successful endovascular trapping of the VADA are sorely needed, to minimize such a complication.

• The Journal of Internal Korean Medicine
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• v.43 no.2
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• pp.166-174
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• 2022

Objective: The aim of this study is to report the effectiveness of Korean medicine for a patient with dizziness following anterior inferior cerebellar artery infarction. Methods: The patient was treated with traditional Korean methods including acupuncture, herbal therapy, moxibustion, and vestibular rehabilitation exercise during an admission period of seven days. The patient's dizziness was assessed using a numeric rating scale (NRS) and the Korean Dizziness Handicap Inventory (K-DHI), Korean Activities-specific Balance Confidence (K-ABC), Korean Vestibular Disorders Activities of Daily Living (K-VADL), the modified Rankin scale (mRS), and the Korean version of the Modified Barthel Index (K-MBI). Results: After seven days of combined treatment with traditional methods and vestibular rehabilitation, the patient's dizziness was reduced from NRS 6-7 to NRS 2. In addition, K-DHI decreased from 84 to 22; K-ABC improved from 52% to 78.125%; K-VADL reduced from 175 to 37; the mRS score changed from 4 to 1; and the K-MBI score increased from 86 to 98. No adverse events were observed during treatment. Conclusion: This study suggests that combined therapy of Korean medicine and vestibular rehabilitation can be effective treatment for anterior inferior cerebellar artery infarction patients.