Sudden Simultaneous Cerebellar Infarction in the Territories of the Medial Division of Posterior Inferior Cerebellar Arteries.

Strokes involving posterior inferior cerebellar arteries (PICA) are rare and usually unilateral. They can involve either the lateral division or the medial division of PICA. Sudden simultaneous cerebellar infarctions in the medial PICA territories are extremely rare. We report one such patient who presented with acute bilateral cerebellar infarctions in the medial PICA territories. She was a diabetic and had features of diffuse atherosclerotic vertebrobasilar disease. We discuss the anatomical peculiarities of PICA and its blood supply along with the clinical features differentiating the medial and lateral PICA infarctions. We also list out the possible mechanisms of bilateral medial PICA territory infarction. Though bilateral they generally have a good prognosis considering the very small area of blood supply.