Posterior Inferior Cerebellar Artery CVA

Aka: Posterior Inferior Cerebellar Artery CVA, Cerebrovascular Accident of PICA, PICA CVA, Lateral Medullary Syndrome

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II. Pathophysiology: Brainstem Tract Involvement

  1. Spinocerebellar Tract
    1. Ataxia
  2. CN 5 Nucleus
    1. Ipsilateral facial pain and TemperatureSensation loss
  3. Spinothalamic Tract
    1. Contralateral extremity pain and Temperature sense loss
  4. Nucleus Ambiguous
    1. Hoarseness (Dysphonia) and difficulty Swallowing (Dysphagia)
  5. Nulceus Solitarius
    1. Taste Sensation loss
  6. Vestibular nucleus
    1. Nystagmus

III. Findings: Signs and Symptoms

  1. Dysarthria
  2. Dysphagia
  3. Dysphonia
  4. Vertigo
  5. Nystagmus
  6. Ataxia or Unsteady gait
  7. Crossed Findings (secondary to involvement of Medulla)
    1. Crossed findings may also occur with vertebrobasilar CVA with Cranial Nerve Involvement
    2. Ipsilateral Horner's Syndrome
    3. Sensory changes
      1. Ipsilateral face
      2. Contralateral body

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