Abstract

The case of a 12-yr-old boy in whom the posterior inferior cerebellar artery (PICA) was discovered to originate from the third vertebral artery segment bilaterally is presented. The patient had become almost completely tetraplegicwithin 3 hr after performing gymnastic exercise on a vaulting horse; there wasno apparent trauma. Bilateral retrograde brachial angiogram revealed an abnormally low origin of the PICA on both sides. Each PICA arose from the third segment of the vertebral artery and curved into the spinal canal between the arches of C1 and C2, giving rise to a small muscular branch at the same level.They then ran upward lateral to the cord. The PICAs apparently had two roots, one larger in caliber with an abnormally low origin, and the other smaller in caliber and in the normal position. The patients condition improved spontaneously, although persistent left-sided hypesthesia to pain and temperature was observed 2 yr after the development of symptoms. Neurologic deficit in this patient could have been due to infarction or intramedullary hemorrhage; although these lesions are rare in young people, spinal cord infarction has occurred as a result of minor trauma in children. Verf.-Referat