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Case report
Yo Kishi
OIKE CLINIC, KYOTO, JAPAN
Corresponding Author
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Background Isolated posterior inferior cerebellar artery dissections can cause subarachnoid hemorrhages or infarctions. Surgical and endovascular treatments for hemorrhagic stroke cases and medical treatments using antithrombotic agents for ischemic stroke cases have been performed, but there are very few reports on nonstroke isolated posterior inferior cerebellar artery dissections, and the treatment strategy for nonstroke cases has not been established. This is the first detailed report on a spontaneously healed, isolated posterior inferior cerebellar artery dissection without stroke, followed by high-resolution MRI examinations.
Case presentation A 48-year-old healthy male felt a severe, throbbing headache on the right side and came to our clinic on the fourth day following onset. MRI examinations revealed a right posterior inferior cerebellar artery dissection and showed no infarctions or hemorrhages. He was observed carefully with continuous monitoring of blood pressure, hydrated sufficiently, and given analgesic anti-inflammatory agents. Two weeks later, the dissected vessel’s diameter grew to the maximum size, though the patient’s headache rapidly improved around that day. Surgical or endovascular treatments for prevention of subarachnoid hemorrhage were recommended, but careful conservative therapy was continued in accordance with the patient’s wishes. Gradually, the dissection finding improved. Four months later, MRI examinations showed his right posterior inferior cerebellar artery was almost normal in size and shape.
Conclusions This is the first detailed report on a nonstroke isolated posterior inferior cerebellar artery dissection that spontaneously occurred and healed, observed by serial high-resolution MRI examinations.
Keywords
Isolated posterior inferior cerebellar artery (PICA) dissection, Headache, Spontaneous healing
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CURRENT STATUS: Published
View the published article at BMC Neurology.
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Posted 29 May, 2019
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Editorial decision: Accept
On 31 May, 2019
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On 30 May, 2019
Editor invited
On 30 May, 2019
Editor assigned
On 30 May, 2019
No comments provided
Editorial decision: Minor revision
On 23 May, 2019
Review #2 received
Received 21 May, 2019
Reviewer #2 agreed
On 06 May, 2019
Reviewer #1 agreed
On 19 Apr, 2019
Review #1 received
Received 19 Apr, 2019
Submission checks complete
On 15 Apr, 2019
Editor invited
On 15 Apr, 2019
Editor assigned
On 15 Apr, 2019
Reviewers invited
Invitations sent on 15 Apr, 2019
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Review #1 received
Received 02 Apr, 2019
Editorial decision: Minor revision
On 02 Apr, 2019
Reviewer #1 agreed
On 20 Mar, 2019
Reviewers invited
Invitations sent on 05 Mar, 2019
Editor invited
On 11 Feb, 2019
Editor assigned
On 11 Feb, 2019
Submission checks complete
On 08 Jan, 2019
No comments provided
Review #1 received
Received 09 Feb, 2019
Editorial decision: Revise
On 09 Feb, 2019
Reviewer #2 agreed
On 17 Jan, 2019
Reviewer #1 agreed
On 09 Jan, 2019
Submission checks complete
On 08 Jan, 2019
Editor invited
On 08 Jan, 2019
Editor assigned
On 08 Jan, 2019
Reviewers invited
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A new preprint design is coming!
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See the published version of this preprint at BMC Neurology.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Case report
Yo Kishi
OIKE CLINIC, KYOTO, JAPAN
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Neurology.
Version 4
Posted 29 May, 2019
No community comments so far
Editorial decision: Accept
On 31 May, 2019
Submission checks complete
On 30 May, 2019
Editor invited
On 30 May, 2019
Editor assigned
On 30 May, 2019
No comments provided
Editorial decision: Minor revision
On 23 May, 2019
Review #2 received
Received 21 May, 2019
Reviewer #2 agreed
On 06 May, 2019
Reviewer #1 agreed
On 19 Apr, 2019
Review #1 received
Received 19 Apr, 2019
Submission checks complete
On 15 Apr, 2019
Editor invited
On 15 Apr, 2019
Editor assigned
On 15 Apr, 2019
Reviewers invited
Invitations sent on 15 Apr, 2019
No comments provided
Review #1 received
Received 02 Apr, 2019
Editorial decision: Minor revision
On 02 Apr, 2019
Reviewer #1 agreed
On 20 Mar, 2019
Reviewers invited
Invitations sent on 05 Mar, 2019
Editor invited
On 11 Feb, 2019
Editor assigned
On 11 Feb, 2019
Submission checks complete
On 08 Jan, 2019
No comments provided
Review #1 received
Received 09 Feb, 2019
Editorial decision: Revise
On 09 Feb, 2019
Reviewer #2 agreed
On 17 Jan, 2019
Reviewer #1 agreed
On 09 Jan, 2019
Submission checks complete
On 08 Jan, 2019
Editor invited
On 08 Jan, 2019
Editor assigned
On 08 Jan, 2019
Reviewers invited
Invitations sent on 08 Jan, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Internal Medicine Specialties
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Neurology.
Background Isolated posterior inferior cerebellar artery dissections can cause subarachnoid hemorrhages or infarctions. Surgical and endovascular treatments for hemorrhagic stroke cases and medical treatments using antithrombotic agents for ischemic stroke cases have been performed, but there are very few reports on nonstroke isolated posterior inferior cerebellar artery dissections, and the treatment strategy for nonstroke cases has not been established. This is the first detailed report on a spontaneously healed, isolated posterior inferior cerebellar artery dissection without stroke, followed by high-resolution MRI examinations.
Case presentation A 48-year-old healthy male felt a severe, throbbing headache on the right side and came to our clinic on the fourth day following onset. MRI examinations revealed a right posterior inferior cerebellar artery dissection and showed no infarctions or hemorrhages. He was observed carefully with continuous monitoring of blood pressure, hydrated sufficiently, and given analgesic anti-inflammatory agents. Two weeks later, the dissected vessel’s diameter grew to the maximum size, though the patient’s headache rapidly improved around that day. Surgical or endovascular treatments for prevention of subarachnoid hemorrhage were recommended, but careful conservative therapy was continued in accordance with the patient’s wishes. Gradually, the dissection finding improved. Four months later, MRI examinations showed his right posterior inferior cerebellar artery was almost normal in size and shape.
Conclusions This is the first detailed report on a nonstroke isolated posterior inferior cerebellar artery dissection that spontaneously occurred and healed, observed by serial high-resolution MRI examinations.
Figure 1
Figure 2
Figure 3
This is a list of supplementary files associated with this preprint. Click to download.
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