ICP and PICA territory cerebellar infarcts most often occur independently but occasionally occur together. The proximal intracranial posterior circulation (P-PC) territory includes structures fed by the intracranial vertebral arteries (ICVAs): the medulla, supplied by small ICVAs branches, and posterior inferior portion of the cerebellum, fed by PICA. It is still unclear why only some patients with acute cerebellar infarcts in the posterior inferior cerebellar artery (PICA) territory present with limb ataxia. Little is written in the literature about this topic, so, in the future, more studies should seek to investigate it.Background: Limb ataxia is classically attributed to cerebellar hemispheric lesions, although isolated lesions of the inferior cerebellar peduncle (ICP) in the medulla may also cause this sign. These results suggest that Vestibular Rehabilitation may have a role in the recovery of PICA strokes, by optimizing the process, thus complementing the regular/standard physiotherapy approach. The degree of independence in functional tasks and activities of daily living also improved.ĭiscussion and conclusions: The main benefit of VR seems to be the optimization of the injured sensor (vestibular system), before promoting the correct sensorimotor integration with the typical physiotherapy interventions. Regarding the scales scores in the two moments of evaluation (1st assessment➔2nd assessment), there were no difference in the MMS (M = 25➔25.2 SD ☒.92➔2.77) but there were positive differences in all others outcome measures - Tinetti (M = 19.8➔27 SD ± 3.35➔1) DHI (M = 37➔11.6 SD ☑5.48➔6,88) and FIM (M = 80.2➔118,8 SD ☑8.29➔7.29). The greatest differences were noted on the ocular and postural stability, balance and gait’s quality, on the inhibition of balance visual compensation strategy and on the decreased rehabilitation time. Results: After 15 sessions all patients improved. The clinical reasoning for the intervention included different VR tasks: gaze stabilization during the early, symptomatic phase, and sensory conflict tasks along with specific balance and gait exercises during a latter phase. The regular protocol for evaluation was used, as well as the Mini Mental State scale (MMS), the Tinetti scale, the Dizziness Handicap Inventory (DHI) and the Functional Independence Measure (MIF). Lateropulsion, gaze-evoked nystagmus and nausea were present. Materials and methods: In this study, 5 patients who suffered a PICA stroke, 2♀ and 3♂, were assessed, between 6 to 10 days after the event and on the 15th session (with the respective informed consent according to declaration of Helsinki). The main objective of this study is to understand the benefits of the vestibular intervention in the early stages of a PICA stroke. Normally in these patients the standard intervention does not included this line of reasoning, ,, , 4 Herdman SJ, Clendaniel R. Vestibular Rehabilitation (VR) aim at reestablish the function of the injured sensory system before introduced neuromotor exercises. These symptoms are related to a compromise of the vestibular afferent sensory input which impairs the motor output for the management/maintenance of balance, ,, ]. After suffering a PICA stroke, patients present vertigo, dizziness, vomiting, headache, changes in gait, changes in postural control and horizontal nystagmus ipsilateral to the lesion, ,, ]. Introduction: The Posterior Inferior Cerebellar Artery (PICA) irrigates the inferior area of the vermis, the central nucleus of the cerebellum, the inferior area of cerebellar hemispheres, the medulla oblongata and the choroid plexus of the fourth ventricle (vestibular nuclear complex) ].
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