Relationship between the Angle of the Posterior Inferior Cerebellar Artery and Cardioembolic Stroke

Sang Hun Lee, Jae Hyung Cha, Il Eok Jung, Sung Wook Yu, Ju Sun Moon, Kyung Hee Cho, Kyung Mi Oh, Chi Kyung Kim, Jin Man Jung

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Background: In patients with unilateral posterior inferior cerebellar artery (PICA) territory infarction, the absence of relevant vessel stenosis may make it difficult to determine the etiology of the infarction. The incidence of cardioembolic (CE) infarction and the factors associated with infarction in such patients remains largely unknown. We hypothesized that the PICA angle would affect the flow direction of embolic sources. Thus, we analyzed the association between high-risk CE sources and the PICA angle. Methods: Patients with an isolated unilateral PICA territory infarction without relevant vessel stenosis who were admitted between 2014 and 2017 were included from the Korea University Stroke Registry, which includes data from 3 university hospitals. We classified patients according to the presence of CE sources. For each case, we measured the angle between the vertebral artery (VA) and the proximal PICA. Results: In all, 71 patients met the final study entry criteria. Multivariable analysis showed that the PICA angle was independently associated with the risk of a CE source. The optimal cut-off value using Youden's index was 89°. We classified the PICA shape based on the optimal cut-off value. A CE source was identified in 83.3% of cases in which the PICA angle exceeded 89°. Conclusions: The angle between the PICA and VA was an independent predictor of unilateral PICA stroke with high-risk CE sources without relevant artery stenosis, suggesting that an angle greater than 89° could be a new image marker for determining the stroke subtype.

Original languageEnglish
Pages (from-to)693-698
Number of pages6
JournalJournal of Stroke and Cerebrovascular Diseases
Issue number3
Publication statusPublished - 2019 Mar

Bibliographical note

Funding Information:
Financial Disclosure: Dr. S.H. Lee received support from the technology development program ( C0502222 ), funded by the Ministry of SMEs and Startups (MSS, Korea).

Publisher Copyright:
© 2018

Copyright 2019 Elsevier B.V., All rights reserved.


  • Cardioembolism
  • PICA angle
  • PICA infarction
  • PICA stroke

ASJC Scopus subject areas

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine


Dive into the research topics of 'Relationship between the Angle of the Posterior Inferior Cerebellar Artery and Cardioembolic Stroke'. Together they form a unique fingerprint.

Cite this