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Mapping affected territory of anterior/posterior inferior cerebellar artery infarction using a vestibular test battery

Abstract Conclusion: Although the affected territory in the posterior/anterior inferior cerebellar artery (PICA/AICA) infarction could not be meticulously demonstrated by magnetic resonance imaging (MRI), it could be picked up by the results of a vestibular test battery comprising caloric, ocular vestibular evoked myogenic potential (oVEMP), and cervical VEMP (cVEMP) tests. Objectives: This study applied audiometry and caloric, oVEMP, and cVEMP tests to map affected territory in patients with PICA/AICA infarction. Methods: Fourteen patients, including 11 with PICA infarction and 3 with AICA infarction, were enrolled in this study during the last 8 years. Each patient underwent audiometry, caloric test, oVEMP test, and cVEMP test. Results: In the PICA group, 8 (36%) of 22 ears had a mean hearing level >25 dB. All six ears (100%) in the AICA group had abnormal hearing, and thus both groups revealed a significant difference. Conversely, significant differences were not observed in the vestibular test battery between the PICA and AICA groups. MRI demonstrated infarction at the brainstem for six patients, while one patient also had cerebellar involvement, indicated by loss of visual suppression on caloric nystagmus. Six patients showed infarction at the cerebellum, and four of them had brainstem affliction based on abnormal oVEMP/cVEMP test results.