Neuro- AICA or PICA?

[dukejen04]

Soooooo- is there any really good way to distinguish between AICA/PICA lesion by symptoms? Especially since they are variable?

I feel like they both present with all kinds of CN issues, nystagmus, vomiting, ataxia, ipisilateral face pain/temp issues, contralateral pain/temp loss.

Is the only real difference that you (may) get Horner's syndrome and hoarseness with PICA (Wallenburg), but not with AICA?

Neuro, grumble....

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[amaprez]

Your avatar is awesome

 

[dreamdoc7]

Also, with AICA, know that u can have ipsilateral facial paralysis which is not seen in PICA.

 

[COdoubleMO2theN]

Just think of the cranial nerves in lateral medulla vs pons ie nucleus solitarius and ambiguous in lateral medulla. That's all you need.

 

[Alvarez13]

Just think of the cranial nerves in lateral medulla vs pons ie nucleus solitarius and ambiguous in lateral medulla. That's all you need.

Exactly. If it's PICA (lateral medullary syndrome), you might see some hoarseness, gag reflex problems. If it's AICA, say good bye to all the facial muscles 😕

 

[AndyRSC]

Posterior inferior cerebellar (lateral medullary) – ipsilateral pain/temperature loss of face (V), contralateral pain/temperature loss, ipsilateral Horner, ipsilateral hoarseness/dysphagia/diminished gag (IX/X), vertigo, nystagmus/diplopia and possibly vomiting (VIII)

Anterior inferior cerebellar – ipsilateral pain/temperature loss of face (V), ipsilateral facial paralysis (VII), ipsilateral sensorineural deafness and nystagmus (VIII), ipsilateral dystaxia (inferior cerebellum)

The underlines may help spot a few more differences.