Occipital artery–posterior inferior cerebellar artery bypass for anterior inferior cerebellar artery stenosis with repeated cerebellar ischemic stroke: a case report

TL;DR

A 77-year-old man with repeated cerebellar strokes underwent a bypass surgery that improved blood flow and prevented further strokes.

Contribution

This case report demonstrates the efficacy of occipital artery–posterior inferior cerebellar artery bypass in treating posterior circulation ischemia.

Findings

The patient had seven recurrent cerebellar infarctions over 2 years due to vascular stenosis.

Bypass surgery improved cerebrovascular reactivity and prevented further ischemic events for 2 years post-surgery.

Abstract

Vertebrobasilar insufficiency revascularization has long been a preventive treatment for cerebral infarction. However, no studies have demonstrated the efficacy of revascularization in patients with cerebellar ischemia.

We present the case of a 77-year-old Japanese man who experienced seven recurrent cerebellar infarctions over 2 years. Severe stenosis was noted at the origin of the common trunk of the posterior inferior cerebellar artery and anterior inferior cerebellar artery. Patients with cerebral infarctions are resistant to medical treatment. Blood flow evaluation showed that the area of reduced cerebrovascular reactivity corresponded to the area where repeated small infarctions occurred. An occipital artery–posterior inferior cerebellar artery bypass was performed to prevent another infarction. Postoperative single-photon emission computed tomography showed an improved cerebrovascular reactivity. No ischemic events occurred during 2 years of a postoperative follow-up period.

Occipital artery–posterior inferior cerebellar artery bypass is an effective treatment method for vascular stenosis and decreased blood circulation due to posterior circulation ischemia.

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