ABSTRACT
Adults with persistent proatlantal intersegmental artery (PPIA) are rarely seen. We present a case of a special type of PPIA that was in a 57-year-old man who presented with dizziness and episodic vertigo of 9â¯months duration. The diagnosis relied on computed tomography angiography and digital subtraction angiography, by which a left internal carotid artery stenosis and an ipsilateral PPIA originating from the external carotid artery (ECA) was found. This special type of PPIA can be described as a ''mixed PPIA'' that originated as Type II from the ECA and coursed as Type I. The patient underwent carotid artery stenting and had no relapse during 3â¯months follow-up. In addition, the literatures on PPIA were reviewed.
Subject(s)
Carotid Artery, External/abnormalities , Carotid Stenosis/diagnostic imaging , Carotid Stenosis/pathology , Carotid Stenosis/surgery , Humans , Male , Middle Aged , StentsABSTRACT
Only a few cases with unilateral internuclear ophthalmoplegia have been reported presenting vertical nystagmus, and few of them provides convincing evidence for the paramedian tract neuron to be a vertical neural integrator. We report a patient who suffered from confined dorsal mid-upper pontine infarction showing unilateral internuclear ophthalmoplegia with upbeat nystagmus in primary position. This case possibly provide evidence that paramedian tract neurons may act as a vertical neural integrator in human.
