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Abstract #0496

Perfusion Weighted MRI is Valuable in Identifying Persisting Vessel Occlusion in Acute Posterior Inferior Cerebellar Artery (PICA) Ischemia

Bukow S, Szabo K, Griebe M, Kern R, Gass A, Lie C, Hennerici M
Universittsklinikum Mannheim, University of Heidelberg

For various reasons most acute MRI studies have focused on anterior circulation stroke. This study analyzes in 16 patients with acute PICA stroke the value of combined diffusion-weighted MRI (DWI), PWI and MRA in acute stroke in the territory of the posterior inferior cerebellar artery (PICA) in comparison with vascular ultrasound ECD/TCCD findings. PWI showed hypoperfusion in the PICA territory in 9/16 patients, demonstrating persistent vessel pathology. Matching results for PWI and MRA and/or ECD/TCCD were found in only 11/16 patients (pattern 1 and 4). In 5/16 patients the results were not matching and PWI was valuable as it either demonstrated lack of hypoperfusion despite indications of arterial obstruction (pattern 2) or demonstrated hypoperfusion indicating persistent vessel pathology, which could not be detected by means of MRA or ECD/TCD (pattern 3). In PICA territory ischemia the high contrast visualization with a combination of DWI and PWI helps to achieve the diagnosis of persistent vessel patholo