What is a PICA dissection?

What is a PICA dissection?

Spontaneous dissection of the posteroinferior cerebellar artery (PICA) is very rare, with only few cases reported in the literature [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15]. Clinically the dissection may cause ischemic stroke or subarachnoid hemorrhage (SAH), depending on the dissecting plane of the affected artery.

Where is the PICA artery?

The posterior inferior cerebellar artery (PICA) is the largest branch of the vertebral artery. It is one of the three main arteries that supply blood to the cerebellum, a part of the brain….

Posterior inferior cerebellar artery
Source Vertebral artery
Branches Medial branch lateral
Vein Inferior cerebellar veins

What is a PICA infarction?

Some strokes affect the brainstem and cerebellum. The Posterior Inferior Cerebellar Artery (PICA) carries blood to this part of the brain. This stroke (Wallenberg’s Syndrome) causes the person to have balance problems and lean to one side. They may also have numbness on one side of the face and body and an eye droop.

Where is a PICA aneurysm?

The PICA is the greatest of the branches of the vertebral artery, and is the causative vessel for aneurysms in the posterior cranial fossa (including dissecting aneurysms), which cause cerebral infarction and cranial nerve compression in many cases.

How serious is a PICA stroke?

It is the most common brainstem stroke. It is typified by vertigo, ipsilateral hemiataxia, dysarthria, ptosis and miosis. Most patients with this stroke recover very well and often resume their previous activities (Nelles et al, 1998). There are rare exceptions.

What causes a PICA stroke?

Most commonly caused by atherothrombotic occlusion of the vertebral artery (then posterior inferior cerebellar arteray and least often the medullary arteries. Vertebral artery dissection associated with: History of trauma, neck. Underlying collagen vascular disease.

What structures does PICA supply?

The PICA supplies the medulla, the choroid plexus and tela choroidea of the fourth ventricle, the tonsils, the inferior vermis, and the inferior aspects of the cerebellar hemispheres 1, 7.

What part of the brain does the basilar artery supply?

Abstract. The basilar artery (BA) serves as the main conduit for blood flow through the posterior circulation. It directly supplies the brainstem and cerebellum and provides distal blood flow to the thalami and medial temporal and parietal lobes.

What is a left PICA aneurysm?

Aneurysms arising from the posterior inferior cerebellar artery (PICA) are uncommon, accounting for 0.5–3% of all intracranial aneurysms. Symptoms and signs usually include subarachnoid hemorrhage, neck pain, dizziness, and coma.

What is a basilar artery stroke?

A basilar artery stroke is a type of posterior stroke, which means it affects circulation at the back of the brain. Because the basilar artery supplies blood to the cerebellum, occipital lobes, and brainstem, all of which have different functions, this type of stroke can present in a number of different ways. 4.

Is PICA a neurological disorder?

Pica etiology is related to gastrointestinal distress, micronutrient deficiency, neurological conditions, and obsessive compulsive disorder. Currently there are no clinical guidelines for situations regarding pica and cases in clinical institutions often go unreported.

What could cause a tear in the basilar artery?

2 A basilar artery stroke occurs when blood flow to the brain is interrupted. This can happen if the vessel becomes blocked (an ischemic stroke) or ruptured (hemorrhagic stroke). The basilar artery is located at the base of the brain, where the two vertebral arteries come together.

Is the posterior inferior cerebellar artery (PICA) involved in vertebral artery dissection?

The posterior inferior cerebellar artery (PICA) is frequently involved in dissection of the vertebral artery (VA); however, isolated PICA dissection has rarely been reported. A 37-year-old man experienced acute and progressive drowsiness, vertigo, occipital headache, vomiting, and ataxia. There was no precedent trauma or chiropractic manipulation.

Is the PICA an enlarged lateral spinal artery?

The idea is that the medullary segment of the PICA is, in fact, an enlarged lateral spinal artery, whereas the vermian and cerebellar branches of the PICA are “coronary” type vessels originating from the “lateral spinal — PICA”, in the same way that SCA and AICA are coronary vessels of the ASA. Here are some “proofs” of the concept:

What is the prognosis of pica dissection without involvement of vertebral artery?

PICA dissection without involvement of the vertebral artery is rare but reported, and usually requires management with sacrifice of the vessel. Endovascular sacrifice is preferred over microsurgical exploration. In appropriate clinical circumstances, balloon occlusion testing of adequacy of collaterals can be considered.

What is the origin of AICA in basilar artery?

AICAs arising higher or lower along the basilar are either results of dominance of higher or lower transverse arteries, or consequent to a relatively “short” basilar artery fusion. C1 origin of PICA reflects dominance of the C1 radiculopial artery, which via the C1 segment of the lateral medullary artery, gives rise to the PICA.