Clinical Presentation Clinical Picture based on Location (Nicholson, 2009). [physio-pedia.com]

• Constitutional Symptom

  Due to negative blood cultures, normal echocardiogram and lack of fever and other constitutional symptoms, we ruled out infective endocarditis. [cureus.com]

• Weight Gain

  These are tapered slowly over several weeks, with careful consideration of potential side effects such as weight gain, mood instability, blood-sugar abnormalities, etc. [reviewofophthalmology.com]

• Thrombosis

  thrombotic (bland) (multiple) (progressive) (silent) (vessel) I82.90 ICD-10-CM Diagnosis Code I82.90 Acute embolism and thrombosis of unspecified vein 2016 2017 2018 2019 Billable/Specific Code Applicable To Embolism of vein NOS Thrombosis (vein) NOS [icd10data.com]

  Unilateral posterior inferior cerebellar artery (PICA) thrombosis is frequent. However, bilateral PICA thrombosis is rare. Herein we report about an intraoperative visualization of a bilateral thrombosis of the telovelomedullary segment of the PICA. [hindawi.com]

  Later, using high-field magnetic resonance imaging (MRI with 3 Tesla and more) in the angiography mode of the cerebral vessels it became possible to obtain an image of atherosclerosis with thrombosis in the vertebral and basilar arteries. [minclinic.ru]

  […] hypophyseal (artery) 433.8 pontine (artery) 433.8 spinal artery 433.8 Raymond (-Céstan) syndrome 433.8 Syndrome - see also Disease anterior Beck's (anterior spinal artery occlusion) 433.8 Céstan (-Raymond) 433.8 pontine 433.8 Raymond (-Céstan) 433.8 Thrombosis [icd9data.com]

  Thrombosis of deep cerebral veins The clinical presentation of thrombosis of the deep cerebral venous system are severe dysfunction of the diencephalon, reflected by coma and disturbances of eye movements and pupillary reflexes. [radiologyassistant.nl]

• Anhidrosis

  Patients often have a Horner's syndrome (unilateral ptosis, miosis and facial anhidrosis). [dizziness-and-balance.com]

  Patients often have a Horner's syndrome (unilateral ptosis, miosis and facial anhidrosis). There also may be saccadic dysmetria (overshoot), saccadic pulsion (pulling of the eye during vertical saccades toward the side of lesion). [tchain.com]

• Tinnitus

  In his patient, neuro-otologic symptoms such as vertigo, tinnitus, and bilateral hearing loss were early symptoms. [ahajournals.org]

  Differential diagnosis Symptoms associated with vertebral artery occlusive disease include dizziness, vertigo, diplopia, perioral numbness, blurred vision, tinnitus, ataxia, bilateral sensory deficits, and syncope, all of which can be caused by other [patient.info]

  It is characterized by recurrent paroxysmal vertigo, tinnitus, ataxia, and nystagmus elicited by head rotation. [journals.plos.org]

• Corneal Edema

  Slit lamp biomicroscopy may demonstrate corneal edema, shallowing of the anterior chamber with anterior bowing of the iris and mild to moderate anterior chamber cell. [reviewofophthalmology.com]

• Background Retinopathy

  Two of the 3 patients with insulin-dependent diabetes mellitus had background diabetic retinopathy, and 1 of the patients with noninsulin-requiring diabetes also had background retinopathy. [academic.oup.com]

• Epistaxis

  A thorough review of systems is crucial in the evaluation of these patients, with a particular focus on systemic signs of rheumatoid arthritis such as joint pain, sinus issues or epistaxis that may be associated with GPA, breathing trouble that may lead [reviewofophthalmology.com]

• Vertigo

  vertigo and had acute onset of isolated SNHL without CP; (4) 4 patients presented with prolonged vertigo and isolated CP without SNHL; (5) 24 patients presented with vertigo but had no accompanying CP or SNHL; (6) one patient presented with prolonged [ahajournals.org]

  […] hemispheres (up to the great horizontal fissure) : cerebellar tonsils, biventral lobule, nucleus gracilis, superior semilunar lobule, inferior portion of the vermis lower part of the medulla Stroke pattern: Common type of cerebellar stroke: headache, vertigo [imaios.com]

  Vertigo is a common early symptom of brainstem strokes. [tchain.com]

  dysarthria, ataxia, weakness or sensory disturbance in some or all of the limbs, and discrete cranial nerve palsies Occlusion of any of major cerebellar arteries vertigo, nausea, vomiting, nystagmus, ipsilateral limb ataxia, contralateral spinothalamic [quizlet.com]

  Clinical symptoms include difficulty swallowing, slurred speech, facial pain, vertigo, Horner syndrome, and possibly palatal myoclonus Otolaryngological features include dysphonia, dysphagia and nasal regurgitation related to ipsilateral vocal fold paralysis [medicine.uiowa.edu]

• Nystagmus

  There was a strong left-beating gaze-evoked nystagmus, and also there was a right-torsional beating torsional nystagmus. Positional testing was abnormal due to the ongoing nystagmus, but there was also a brief upbeating nystagmus. [dizziness-and-balance.com]

  More or less complete dorsal lateral medullary syndrome (Wallenberg syndrome) if the medulla is involved: ipsilesional vestibular (vertigo, vomiting, nystagmus, lateropulsion), V, IX and X cranial nerve palsies, Horner syndrome, appendicular ataxia with [imaios.com]

  The other 3 showed seesaw, upbeat, or pure torsional nystagmus. Asymmetrical bidirectional gaze-evoked nystagmus was also found in 35 patients. [ahajournals.org]

  In the author's experience, these patients often exhibit rebound nystagmus, which is a variant of gaze-evoked nystagmus. [tchain.com]

  Vertigo, nausea, vomiting, and nystagmus result from involvement of the vestibular nuclei. 2. Hoarseness and dysphagia are caused by involvement of the dorsal motor nucleus of the vagus (X) nerve, nucleus solitarius, and nucleus ambiguous. 3. [youtube.com]

• Dizziness

  Case presentation We report the case of a 74-year-old Italian woman who presented with a complaint of dizziness. [paperity.org]

  A 78-year-old man with a history of hypertension and smoking presented with sudden dizziness, nausea and vomiting; there was no history of recent trauma and arm claudication. [ommegaonline.org]

  Anyone who experiences severe chest pain, dizziness, and fainting, or problems breathing should seek emergency care. [medicalnewstoday.com]

  Clinical manifestation of atherothrombotic occlusion in the vertebral and posterior inferior cerebellar arteries (PICA) basin Transient ischemic attacks (TIA), which develop with insufficient blood supply in the basin of the vertebral artery, causes dizziness [minclinic.ru]

  Case of Wallenberg's syndrome: A man in his 50's developed dizziness after a brainstem stroke, experienced 2 months ago. The stroke was due to a cardiac arrhythmia, and at one point the vertebral artery on the right was blocked. [dizziness-and-balance.com]

• Dysmetria

  There are strong influences of both gaze and gravity, but relatively little limb dysmetria. References Caplan LR. Vertebrobasilar disease. In Barnet HJM (and others, Eds), Stroke: Pathophysiology, Diagnosis and Management. [dizziness-and-balance.com]

  Etiology Clinical features Clinical features Structure affected Ipsilateral Dysphagia ↓ Gag reflex Hoarseness, dysphonia Nucleus ambiguus (motor neuron) Ataxia, dysmetria, dysdiadochokinesia Inferior cerebellar peduncle Horner syndrome Uncontrollable [amboss.com]

  Symptoms include: vomiting, vertigo, nystagmus, pain and temperature sensation from ipsilateral face and contralateral body, dysphagia, hoarseness, diminished gag reflex, ipsilateral Horner syndrome ; ataxia, dysmetria. [stepwards.com]

  This syndrome is known as the Wallenberg or “lateral medullary” syndrome, and may include the following signs and symptoms: Vertigo, nausea, vomiting Ipsilateral limb ataxia (dysmetria, dysdiadochokinesia) Gait ataxia Nystagmus Ipsilateral Horner’s syndrome [casemed.case.edu]

  The patient was clearly conscious with a Glasgow Coma Scale (GCS) of 15 but had a left-sided Wallenberg’s syndrome, right brachial weakness (M4), left central facial paresis, left lateral gaze nystagmus, dysarthria, bilateral dysmetria on finger-to-nose [hindawi.com]

• Myoclonus

  Clinical symptoms include difficulty swallowing, slurred speech, facial pain, vertigo, Horner syndrome, and possibly palatal myoclonus Otolaryngological features include dysphonia, dysphagia and nasal regurgitation related to ipsilateral vocal fold paralysis [medicine.uiowa.edu]

  There was still no palatal myoclonus. Cerebellar examination continued to be nearly normal, although a little better on the left (his nondominant side). The pupils remained smaller on the right. [dizziness-and-balance.com]

  A review of 29 cases of lateral bulb infarction, including PICA injury, showed symptoms of dysphagia, dysarthria, ataxia, dysmetria, dysdiadokokinesia, facial pain, vertigo, nystagmus, Horner syndrome, diplopia and myoclonus.6 Although not all symptoms [scielo.br]

  Partial deafness, tremor of the upper extremity, an ipsilateral Horner syndrome and palatal myoclonus have been reported. Clinically, this stroke may be impossible to distinguish from a partial AICA or PICA territory stroke. [tchain.com]

Workup did not show evidence for cardioembolic or atheroembolic source. The presence of an extradural origin of PICA may be considered a predisposing factor for non-traumatic LMS associated with head and neck movement. [link.springer.com]

Workup All patients presenting with scleritis should be worked up for associated systemic disease. [reviewofophthalmology.com]

Moreover, cardiac workup showed no evidence of intramural thrombus, endocarditis or atrial fibrillation in our patient. [cureus.com]

Safety and efficacy of this treatment modality are unclear. [neurologyindia.com]

Conclusion The heterogeneity of PICA anatomy renders preoperative characterization of angioarchitecture and locoregional anatomy critical in the treatment of PICA aneurysms. [asianjns.org]

They provided a new treatment option for VA dissecting aneurysms involving the origin of PICA. In this letter, we will discuss alternative treatment options for these complex aneurysms. [ajnrblog.org]

Steve Roach, Kerstin Bettermann, and José Biller have completely revised and updated sixth edition of the highly respected standard for stroke diagnosis and treatment, adding chapters on genetics, pregnancy-related stroke, and acute treatment. [books.google.com]

[…] of aneurysms, good prognosis. 36 Fig. 2 Lv/2010[23] 41/M Not mentioned stent in coil Followed up for 6 months, imaging revealed complete occlusion of aneurysms, good prognosis. 37 Fig. 2 Lv/2010[23] 41/M Not mentioned stent in coil Followed up for 36 [medsci.org]

Older individuals and ones with a higher grade of severity when admitted have a higher chance of a poor prognosis. [brain-surgery.com]

This rare type of infarction shows a good prognosis without accompanying acute hydrocephalus. Case report. A 71-year-old man with a history of hypertension presented with an abrupt gait disturbance. [n.neurology.org]

The etiological cause was thought to be intracranial vertebral artery occlusion with a baseline insitu atherosclerosis, in the presence of branches having their origin from one side and going to both PICA territories. [dusunenadamdergisi.org]

Etiology Clinical features Clinical features Structure affected Ipsilateral Dysphagia ↓ Gag reflex Hoarseness, dysphonia Nucleus ambiguus (motor neuron) Ataxia, dysmetria, dysdiadochokinesia Inferior cerebellar peduncle Horner syndrome Uncontrollable [amboss.com]

It is important to contrast these clinical manifestations with those involving strokes of the anterior circulation, as the etiology and treatment may differ. [casemed.case.edu]

Etiology: Most commonly caused by atherothrombotic occlusion of the vertebral artery (then posterior inferior cerebellar arteray and least often the medullary arteries. [medicine.uiowa.edu]

These findings highlight that the cause of cerebral infarction can be related not only cerebral ischemia but also other etiologies. [ommegaonline.org]

Posterior Scleritis: Analysis of Epidemiology, Clinical Factors, and Risk of Recurrence in a Cohort of 114 Patients. Ocul Immunol Inflamm 2016;24:1: 6-15. 2. Auer, Herborn, Indocyanine green angiographic features in posterior scleritis. [reviewofophthalmology.com]

Epidemiology, Etiology & Prognosis A study reviewing 25 cases of Wallenberg Syndrome found the incidence to be highest in middle-aged men at 55.06 years of age[2]. [physio-pedia.com]

In Barnet HJM (and others, Eds), Stroke: Pathophysiology, Diagnosis and Management. New York: Chrchill-Livingstone, pp 549-619, 1986 Faught E, Oh SJ. Brainstem auditory responses in brainstem infarction. [dizziness-and-balance.com]

Palinopsia, micropsia, and macropsia These are illusory phenomena that are of uncertain pathophysiology. Palinopsia describes the persistence of a visual image for several seconds to days in a partially blind hemifield. [emedicine.medscape.com]

Epidemiology, pathophysiology, diagnosis and management of intracranial artery dissection. Lancet Neurol. 2015;14:640–54. 5. Matsumoto J, et al. [bmcneurol.biomedcentral.com]

Metabolic syndrome: Definition, pathophysiology, and mechanisms. Am Heart J. 2005;149:33–45. [PubMed] [Google Scholar] 7. Olofsson SO, Wiklund O, Boren J. [ncbi.nlm.nih.gov]

Pathophysiology Atherosclerosis: the most common vascular disease affecting the vertebrobasilar system[1]: This affects large vessels, causing narrowing and occlusion. [patient.info]

Neck clipping was performed via a midline suboccipital approach in the prone position to prevent re-rupture 2 months after admission [ Figure 3 ]. [surgicalneurologyint.com]

We provide two case presentations where the outcome was predicted and certain morbidities prevented with the employment of a multimodal neuromonitoring paradigm. [cureus.com]

See also the separate Stroke Prevention article. [patient.info]

The other case of the reported two iPICAD without stroke was surgically treated to prevent subarachnoid hemorrhage because the dissection finding by radiological examination was progressive [8]. [bmcneurol.biomedcentral.com]