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Cerebellar top-of-the-basilar syndrome

I E Silverman1, M D Geschwind, J J Vornov

  • 1Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Clinical Neurology and Neurosurgery
|January 8, 1999
PubMed
Summary

This study details a rare brain vascular anomaly where anterior and posterior circulations lack connection, leading to a unique cerebellar top-of-the-basilar syndrome with bilateral superior cerebellar artery infarctions.

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Area of Science:

  • Neurology
  • Vascular Anatomy
  • Embryology

Background:

  • The Circle of Willis typically ensures collateral blood flow between anterior and posterior cerebral circulations.
  • Variations in the Circle of Willis can predispose individuals to specific cerebrovascular pathologies.

Observation:

  • A patient presented with an absence of normal anastomosis between the anterior and posterior cerebral circulations.
  • The patient exhibited bilateral fetal posterior cerebral arteries, a developmental variant.

Findings:

  • This unique vascular anatomy resulted in an atypical 'cerebellar' presentation of top-of-the-basilar syndrome.
  • Bilateral superior cerebellar artery infarctions were observed as a consequence of this anomaly.

Implications:

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  • Understanding rare cerebrovascular variations is crucial for accurate diagnosis and treatment of stroke.
  • This case highlights the importance of embryologic origins in explaining complex vascular presentations.