Agenesis of posterior inferior cerebellar arteries in an asymptomatic adult with Dandy—Walker malformation

ECG, 24-hour blood pressure monitor test, a tilt test to measure response in terms of heart rate and blood pressure, and the EEG all delivered normal results. Findings from the neurological and cognitive tests were normal. Brain neuroimaging studies were performed. In Fig. 1, the sagittal brain MR image on the A side showed DWM. The supratentorial ventricles, cerebral cortex, corpus callosum, brainstem, and mesencephalic duct all appeared to be normal. On the medial slice of side A, Arrow 1 points to the entire length of the basilar artery. The cerebellar vermis is absent, and we see a small wing-shaped part of the upper cerebellum. In a paramedial slice on side B, arrows 2 and 3 indicate the anterior, superior, and inferior cerebellar parenchyma, respectively. Angio-RM revealed that neck and supratentorial arteries were normal. Side C of Fig. 2 shows a frontal view, and side D, an oblique view, of the arteries of the posterior fossa. Arrow 1, along the final segment of the vertebral arteries, shows the lack of posterior inferior cerebellar arteries (PICA). Arrow 2 indicates the basilar trunk; Arrow 3 shows the posterior cerebral terminal branches; Arrow 4 shows the superior cerebellar colateral branches; and Arrow 5, the anterior inferior cerebellar arteries (AICA). One year after the syncopic episode, the patient had not experienced symptom recurrence, and was able to carry out daily activities normally. enesis of posterior inferior cerebellar teries in an asymptomatic adult with ndy—Walker malformation