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Query: UMLS:C0004134 (ataxia)
 15,886 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report 10 cases of cerebellar infarction in the territory of the medial branch of the posterior inferior cerebellar artery (mPICA). Axial sections on MRI through the middle of the medulla and the cerebellum showed the infarction as a triangular area with a dorsal base and a ventral apex directed towards the fourth ventricle. The infarct also involved the lateral and dorsal medulla when the mPICA supplied all or part of these regions. Three clinical patterns were observed: 1) pseudolabyrinthine signs with or without dysmetria and ataxia when the medulla was spared; marked axial lateropulsion was present in most cases; 2) complete or incomplete Wallenberg's syndrome, when the medulla was involved; 3) silent infarction. These syndromes are precisely those previously attributed to PICA occlusion without distinction of the branch involved. No alteration of consciousness was recorded and spontaneous recovery was the rule. Cerebellar infarction in the distribution of the mPICA can be regarded as a benign condition with a good prognosis.
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PMID:Infarction in the territory of the medial branch of the posterior inferior cerebellar artery. 224 54

Of 1,994 yearling and 2-year-old cattle in a winter feeding program, 117 died within 42 days of being fed toxic amounts of monensin sodium in a liquid protein supplement. Death losses commenced on the third day after ingestion of a toxic amount in the feed. Clinical signs in cattle that died in less than 9 days included anorexia, pica, diarrhea, depression, mild hindlimb ataxia, and dyspnea. Gross necropsy findings in cattle dying in the acute phase of the illness included hydrothorax, ascites, and pulmonary edema, as well as petechial hemorrhages, edema, and yellow streaking in skeletal and cardiac muscle. Cattle dying after 9 days had gray streaks in heart and skeletal muscle, generalized ventral edema, enlarged, firm, bluish discolored liver, and enlarged heart. Microscopic changes in cattle dying in the acute phase (less than 9 days) consisted of pulmonary edema, congestion, and hemorrhage. Cardiac and skeletal muscle had localized areas of edema, hemorrhage, and coagulative necrosis. In cattle dying after 9 days of illness, the changes included lymphocytic infiltration, sarcolemmal nuclear proliferation, and fibrosis in skeletal and cardiac muscle. Lungs contained increased alveolar macrophages and a few neutrophils. Centrilobular necrosis and mild fibrosis were found in the liver. Changes varied somewhat according to the area of heart or skeletal muscle that was affected. Active muscles, eg, those in the heart ventricles and diaphragm, were altered most severely. Intoxication appeared to be a result of sedimentation of monensin in the molasses carrier to give remarkable concentrations of the substance at the bottom of the holding tank.
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PMID:Accidental monensin sodium intoxication of feedlot cattle. 673 46

The territory of the lateral branch of the posterior inferior cerebellar artery (1PICA) supplies the anterolateral region of the caudal part of the cerebellar hemisphere. Because infarcts in the territory of the 1PICA have rarely been studied specifically, 10 patients with this type of infarct are reported. An 1PICA infarct was isolated in only three patients, whereas it was associated with brainstem infarct in four, with occipital infarct in one, and with multiple infarcts in two patients. The most common symptom at onset was acute unsteadiness and gait ataxia without rotatory vertigo (six patients). Unilateral cerebellar dysfunction was found in all patients, with limb ataxia (nine patients), dysdiadochokinesia (five patients), and ipsilateral body sway (four patients), but dysarthria and primary position nystagmus were notably absent. In the patients with a coexisting infarct in the brainstem, cranial nerve and sensorimotor dysfunction was prominent and often masked the signs of cerebellar dysfunction. Unlike other infarcts in the PICA territory, 1PICA territory infarcts were mainly associated with vertebral artery atherosclerosis (six patients), whereas cardiac embolism was less common (three patients). Unilateral limb ataxia without dysarthria or vestibular signs suggests isolated 1PICA territory infarction and should allow its differentiation from other cerebellar infarcts.
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PMID:Infarcts in the territory of the lateral branch of the posterior inferior cerebellar artery. 808 72

We report the case of a 34-year-old man, treated by chiropractic manipulation for tension-type headache. The patient complained of a sharp occipital pain during the first session, followed by vomiting and loss of consciousness, and remained comatose for five days. Neurological examination detected persistence of dysarthria, ataxia, with delayed responses. Neuroradiological findings reveal an ischemic lesion in left PICA region, confirmed by angiography. Clinical and radiological findings suggested complete remission about two months later.
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PMID:Chiropractic complications. Another case report. 832 26

To get a better insight into the clinical differentiation between vertigo of cerebrovascular origin and of aural origin, we investigated radiologically proven stroke patients who presented with vertigo as an initial clinical manifestation. Of 154 stroke patients, 30 patients with vertigo (20%) had the relevant lesion, demonstrated with the initial computerized tomographic scan (13 patients) or the follow-up magnetic resonance imaging (MRI) study (17 patients) of the brain. Every lesion was in the vertebrobasilar arterial territory; 19 in the cerebellum, 8 in the pons, and 3 in the medulla oblongata. Although 12 of the 30 patients (40%) presented with vertigo in isolation at the onset of stroke, eight patients (27%) developed additional neurologic abnormalities from four hours to seven days later. Patients with isolated vertigo (13%) had the small lesion exclusively in the cerebellum of the PICA medial branch territory. The most frequent accompanying neurological sign was swaying in the cerebellar and medullary lesion, and dysarthria in the pontine lesion. The direction of nystagmus or swaying did not match the lesion side in some patients. Our findings suggest that cerebellar stroke may commonly manifest isolated vertigo or vertigo with swaying mimicking labyrinthine disorder, particularly at the onset of the disease. MRI study and tests for truncal ataxia and lateropulsion may be crucial for the detection of vertigo of cerebrovascular origin.
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PMID:Vertigo of cerebrovascular origin proven by CT scan or MRI: pitfalls in clinical differentiation from vertigo of aural origin. 896 9

We studied clinical manifestations of sixteen patients with cerebellar infarcts diagnosed by MRI. In fourteen of them, the stroke developed abruptly with vertigo, which continued for several days. At the early stage of illness, ataxia was obscure. But after vertigo and nausea disappeared, nine cases showed truncal ataxia, while limb ataxia was found in only five. Their vertigo was rotatory and aggravated by head movement. Gaze-evoked nystagmus was observed in only 5 cases. Four patients preferred to take unilateral posture since they experienced less vertigo. The side of their lesions was the lower side of their posture. Limb ataxia was more frequent in SCA-involving cases than in SCA-non involving cases (3 out of 6 vs 2 out of 10, respectively). On the other hand, headache was more frequent in PICA-involving cases than in PICA-non-involving cases (6 out of 11 vs 1 out of 5, respectively). Ataxic gait was seen more in medial branch-involving cases than medial branch non-involving cases (5 out of 6 vs 4 out of 10, respectively). One patient died due to obstructive hydrocephalus.
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PMID:[A study of MRI and clinical neurology in acute cerebellar infarcts]. 939 54

We present a case of a spontaneous dissecting aneurysm at the vertebrobasilar artery including the right PICA in a 44-year-old man, who suffered from headache, hiccup and ataxic gait. The arteriograms showed an irregular narrowing and dilatation in the right PICA and in the vertebrobasilar artery, and showed fusiform dilatations in the bilateral middle cerebral arteries. We observed intramural hematoma and true lumen at the right PICA dissecting aneurysm on T1-weighted images on magnetic resonance imaging (1.5T, MRI), and the intimal flap was enhanced on T1-weighted image after intravenous injection of Gd-DTPA. The shape of the intramural hematoma showed a unique "two dumplings on a skewer" appearance, and the intensity of its hematoma in the false lumen decreased in gradient from adventitia to intimal flap on T1-weighted image on MRI. The dissecting aneurysm of the PICA was occluded spontaneously 1 month later, and it caused cerebellar infarction. However, the patient has been left only with the symptom of slight trunkal ataxia. Various shapes of intramural hematomas on MRI have been reported by Kitanaka in association with intracranial vertebrobasilar dissections. We suggest that "two dumplings on a skewer" shape which corresponds to the flow void of the true lumen, accompanied by intramural hematoma and enhanced intimal flap, on contrast-enhanced T1-weighted image, should be regarded as a true "diagnostic sign" of a dissecting aneurysm.
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PMID:[Spontaneous occlusion of a dissecting aneurysm in the shape of "two dumplings on a skewer" at righ posterior inferior cerebellar artery (PICA): report of a case and neuroradiological findings]. 1087 15

A case is reported of the vertebral arterial dissection presenting initially with cerebellar infarction, and which subsequently occurred with subarachnoid hemorrhage 14 days later. A 75-year old male was admitted because of vertigo and ataxia. MR T2-weighted imaging showed a hyperintensity areas on the left cerebellar hemisphere and MR angiography showed multiple stenotic lesions in the left vertebral artery. We diagnosed his illness as dissection of the left vertebral artery and antiplatelet therapy and the blood pressure control were carried out. Fourteen days after the onset, the patient complained of sudden onset of headache and subarachnoid hemorrhage was confirmed on CT scan. Proximal clip occlusion of the left vertebral artery and OA-PICA anastomosis was carried out immediately. The patient was discharged with slight truncal ataxia. We evaluated the features of this vertebral arterial dissection presenting with subarachnoid hemorrhage after ischemic stroke with reference to another reported cases.
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PMID:[Vertebral arterial dissection with subarachnoid hemorrhage after ischemic onset]. 1112 96

Central vertigo is most often expressed by a feeling of dizziness, non or badly systematized, but it can also appear, more seldom, like an isolated acute vertigo or associated to other neurological signs. A precise clinical exam can lead to evidence essential clinical informations (significant ataxia, neurological signs, gaze nystagmus, pursuit anomaly,...). Almost all acute lesions of central vestibular pathways, as for the peripheral ones, lead to a harmonious vestibular syndrome. The vascular lesion of the vertebro-basilar territory and multiple sclerosis are two main causes to it. The pseudo-labyrinthine forms are essentially described in occlusion infarcts of the AICA and PICA, but a hematoma can lead to the same picture; the diagnostic of multi- or monosymptomatic forms with a peripheral lesion is often very difficult, the classical classification of the central and peripheral vestibular syndromes has become obsolete and should be abandoned.
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PMID:[Vertigo and pathology of the cerebellospinal system]. 1649 49

The cerebellum has almost never been considered responsible for conjugate deviation of the eyes (CDE). A few cases of CDE caused by cerebellar lesions without the involvement of the brainstem have been reported, but the lesions were too large to evaluate their localization in the cerebellum. In this report, we describe 2 cases of isolated CDE caused by small cerebellar vascular lesions and a case of CDE and staggering gait that occurred following cerebellar infarction. We further describe cases of head rotation without CDE and those of vertigo without CDE or head rotation due to a similar small lesion. Case 1: A 73-year-old woman with rheumatism was brought to our department because of sudden-onset of difficulty in looking to the right. She was admitted 3 hours after onset; at admission she was alert and well-oriented and denied both vertigo and nausea. Neurologic examination revealed CDE to the left; however, no limb ataxia was detected. Diffusion-weighted MRI showed a small infarction in the white matter of the right PICA area near the vermis. Her CDE disappeared spontaneously within 2 days. Case 2: A 79-year-old man with hypertension exhibited CDE to the right without vertigo or ataxia following a small hemorrhage in the cerebellan area mentioned in Case 1. Case 3: A 65-year-old man with hypertension presented with CDE to the right and staggering gait after a small infarction in an area lateral to that mentioned above. The first 2 cases suggest that a small cerebellar vascular lesion can produce isolated CDE to the side contralateral to the lesion. The region responsible for CDE in these cases was located in the white matter of the PICA area near the vermis, although similar lesions in Cases 4 and 5 produced no CDE.
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PMID:[Small cerebellar vascular lesion can produce isolated conjugate deviation of the eyes]. 1856 61


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