A Case of Vestibular and Oculomotor Pathology from Bilateral AICA Watershed Infarcts Treated with Basilar Artery Stenting
Kattah, Jorge C.
Wang, David Z.
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Bilateral AICA infarcts may be the result of impaired arterial flow in watershed territories that overlap with PICA and SCA brainstem/cerebellar circulation among patients with critical basilar artery stenosis (1-3). We report one such patient with watershed bilateral AICA infarcts. She had a two-week history of progressive truncal ataxia, frequent falls, dysarthria and episodic vomiting. Examination suggested brainstem/cerebellar localization. She had bilateral symmetric infarcts of the cerebellar flocculus and middle cerebellar peduncles (MCP) due to tandem proximal and mid-basilar artery (BA) stenosis. Failure to improve on maximal medical therapy led to BA angioplasty/ stenting, with improved brainstem/cerebellum circulation and neurologic deficits.
Basilar Artery stent