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[Bilateral middle cerebellar peduncle infarcts caused by bilateral vertebral artery occlusion: a case report]

Xiao-qing Wu1, Bao-rong Zhang1

  • 1Department of Neurology，Second Affiliated Hospital，Zhejiang University School of Medicine，Hangzhou 310009，China.

Zhejiang Da Xue Xue Bao. Yi Xue Ban = Journal of Zhejiang University. Medical Sciences
|November 6, 2014
PubMed

Insights

Bilateral vertebral artery occlusion can cause rare middle cerebellar peduncle infarction. Prompt treatment with volume expansion and antiplatelet therapy led to a patient's full recovery.

Area of Science:

  • Neurology
  • Vascular Neurology
  • Neuroimaging

Background:

  • Bilateral vertebral artery occlusion is associated with a high risk of cerebral infarction and poor outcomes.
  • Cerebral infarction affecting the bilateral middle cerebellar peduncle (MCP) is exceptionally rare, with limited documented cases.

Observation:

  • A 74-year-old male presented with 13 days of dizziness and gait instability.
  • Brain MRI revealed acute infarction in the bilateral middle cerebellar peduncles.
  • Digital subtraction angiography demonstrated occlusion of the left vertebral artery origin and the entire right vertebral artery, alongside significant collateral circulation and recanalization.

Findings:

  • The patient received treatment including volume expansion, anti-platelet aggregation, and lipid-lowering therapy.
  • Following treatment, the patient's symptoms of dizziness and walking instability resolved completely.

Implications:

  • This case highlights that even rare presentations of bilateral middle cerebellar peduncle infarction secondary to vertebral artery occlusion can be successfully managed.
  • Early diagnosis and aggressive management, including supportive care and vascular interventions, are crucial for favorable prognoses in such critical neurological events.
  • Further research into the specific mechanisms and optimal treatment strategies for bilateral MCP infarction is warranted.

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