If the timing of diagnosis fits within 4.5 hours of the onset of symptoms, then patients can be treated with thrombolysis 9. Acute endovascular therapies, often in the form of lysis or clot removal, can be used, particularly in basilar artery occlusion 10. Treatment of posterior inferior cerebellar artery, and posterior circulation strokes in general, depends upon the nature, timing, and severity of symptoms. In the first twenty-four hours, studies show approximately 75-95% sensitivity for MRI diffusion-weighted images, compared to CT of 16% 8. MRI is far superior to CT in the sensitivity of acute ischemic stroke across all vascular territories.
MR angiography and CT angiography both have very high sensitivity for vessel occlusion identification, at 87% and 100% respectively 7. CT angiography should be utilized if the patient fits thrombolysis therapy guidelines 6. Variations are common and the PICA syndrome for example, often presents with facial pain as the initial symptom and hypoalgesia, affecting either side of face 5.Īs with all cases of suspected stroke, CT or MRI is required urgently to exclude hemorrhagic stroke.
There are multiple eponymous posterior stroke syndromes, often presenting incompletely 4.
#Pica syndrome icd 10 full#
Headache and neck pain is normally the result of full posterior inferior cerebellar artery territory infarcts and is likely secondary to the associated swelling and mass effect 3. Signs of a lateral medullary syndrome may coexist in ~30% 2. Vertigo, nausea and truncal ataxia are the most common presenting features.
Typically considered the most common territory involved in cerebellar infarction, although at least one study 1 has demonstrated similar frequencies of PICA and superior cerebellar artery (SCA) infarcts.
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