Figure 4.

A flow diagram to delineate the possible pathophysiology between hyperthyroidism, SMAS, and cerebellar infarction. Hyperthyroidism-related vasculopathy, vascular wall inflammation, and sympathetic stimulation have been proposed to be directly related to cerebellar infarction. SMA syndrome was related to visceral fat decrease and impingement of duodenum by aorta-SMA angle, which further worsened the already decreased body weight and visceral body fat, further depleted intravascular volume, and aggravated cerebellar ischemia/infarction. A hypoplasia of left vertebral artery may attribute to cerebellar infarction despite a minor role. SMAS = superior mesenteric artery syndrome.