Skip to main content
SpringerLink
Log in

The course of the posterior inferior cerebellar artery may be related to its level of origin

  • Original Article
  • Published:
Surgical and Radiologic Anatomy Aims and scope Submit manuscript

Abstract

The course of the posterior inferior cerebellar artery (PICA) was analyzed with reference to its origin and relationships with the medullary and cerebellar surfaces and the adjacent cranial nerves in 40 brains after the injection with acrylic resins of the vertebrobasilar system. In 42.5% of instances, the PICA originated from the lateral medullary segment of the vertebral artery (VA), in 32.5% from its premedullary segment, in 22.5% from the basilar artery (BA), and in 2.5% it was absent. With reference to the level of origin, three patterns of course for the lateral medullary segment of the PICA can be outlined. (1) When it arises from the lateral medullary segment of the VA, it passes below the hypoglossal nerve, and the lateral medullary segment may form a loop with an anterosuperior convexity towards the pontomedullary sulcus (41%), or it may follow a rectilinear course (41%). It passes at the level of the accessory nerve. The tonsillomedullary (TM) segment shows a caudal loop and the telovelotonsillary (TVT) has a cranial loop. (2) When the PICA arises from the BA, it passes above the hypoglossal nerve. The lateral medullary segment forms a loop with lateral convexity (78%) and passes above or through the glossopharyngeal nerve, frequently showing a recurrent course among the roots of the IX, X, or XI cranial nerve. The TM and the TVT segments do not have loops. (3) When the PICA arises from the premedullary segment of the VA, it passes above, below, or through the rootlets of the hypoglossal nerve. In the lateral medullary segment, it follows a rectilinear course (54%) and passes the plane formed by the IX, X, and XI cranial nerves at an intermediate level with respect to the other two patterns. The TM and the TVT segments show caudal and cranial loops. The different origins and courses of the PICA derive from the selection of different branches of the primitive vertebrobasilar plexus during the development of the cerebellum. The existence of an embryologic correlation between the course of the PICA and its level of origin may be useful in the evaluation of its angiographic anatomy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1 Fig. 2 Fig. 3

Similar content being viewed by others

References

  1. Adachi B (1928) Das Arteriensystem der Japaner. Verlag der Kaiserlich-Japanischen Universität, Kyoto, 1:119–134

  2. Amarenco P, Hauw JJ (1989) Anatomie des artères cérébelleuses. Rev Neurol Paris 145:267–276

    CAS  Google Scholar 

  3. Bhuller A, Sanudo JR, Choi D, Abrahams PH (1998) Intracranial course and relations of the hypoglossal nerve. An anatomic study. Surg Radiol Anat 20:109–112

    CAS  PubMed  Google Scholar 

  4. Çavdar S, Dalcik H, Yalin A (1995) A rare case of the posterior inferior cerebellar artery. Acta Anat 152:234–236

    Google Scholar 

  5. Chung SS, Chang JW, Kim SH, Chang JH, Park YG, Kim DI (2000) Microvascular decompression of the facial nerve for the treatment of hemifacial spasm: preoperative magnetic resonance imaging related to clinical outcomes. Acta Neurochir 142:901–906

    Article  CAS  Google Scholar 

  6. De Caro R, Parenti A, Munari PF (1991) Fenestration of the vertebrobasilar junction. Acta Neurochir 108:85–87

    Google Scholar 

  7. De Caro R, Parenti A, Munari PF (1995) Course of the caudal hypoglossal rootlet through the vertebral artery. J Anat 187:499–501

    PubMed  Google Scholar 

  8. De Caro R, Serafini MT, Galli S, Parenti A, Guidolin D, Munari PF (1995) Anatomy of segmental duplication in the human basilar artery. Possible site of aneurysm formation. Clin Neuropath 14; 303–309

    Google Scholar 

  9. De Caro R, Parenti A, Munari PF (1996) Persistent primitive lateral vertebrobasilar anastomosis. Acta Neurochir 138:592–594

    Google Scholar 

  10. Dinichert A, Rufenacht DA, de Tribolet N (2000) Dissecting aneurysm of the posterior inferior cerebellar artery: report of four cases and review of the literature. J Clin Neurosci 7:515–520

    CAS  PubMed  Google Scholar 

  11. Fankhauser H, Kamano S, Hanamura T, Amano K, Hatanaka H (1979) Abnormal origin of the posterior inferior cerebellar artery. Case report. J Neurosurg 51:569–571

    CAS  PubMed  Google Scholar 

  12. Francke JP (1971) Contribution a l’étude des artères vertébrales. Thèse médecine, Lille

  13. Heimans JJ, Valk J, Lohman AHM (1985) Angiographic anatomy of the anterior inferior cerebellar artery. Springer, Berlin Heidelberg New York

  14. Jelicic N, Draganic V, Jovanovic S (1985) Sur l’artère cérébelleuse inférieure postérieure. Acta Anat 121:179–183

    CAS  Google Scholar 

  15. Jinkins JR (2000) Atlas of neuroradiologic embryology, anatomy, and variants. Lippincott, Philadelphia, pp 337–343

  16. Lasjaunias P, Guibert-Trainer F, Braun JP (1981) The pharyngo-cerebellar artery or ascending pharyngeal artery origin of the posterior inferior cerebellar artery. J Neuroradiol 8:317–325

    CAS  PubMed  Google Scholar 

  17. Lasjaunias P, Vallée B, Person H, Ter Brugge K, Chiu M (1985) The lateral spinal artery of the upper cervical spinal cord. Anatomy, normal variations, and angiographic aspects. J Neurosurg 63:235–241

    CAS  PubMed  Google Scholar 

  18. Lasjaunias P, Berenstein A, ter Brugge KG (2001) Surgical neuroangiography. Springer, Berlin Heidelberg New York, p 526

  19. Lazorthes G, Gouazé A, Salamon G (1976) La vascularisation artérielle du cervelet, in Vascularisation et circulation de l’encéphale. Masson, Paris

  20. Lister JR, Rhoton AL Jr, Matsushima T, Peace DA (1982) Microsurgical anatomy of the posterior inferior cerebellar artery. Neurosurgery 10:170–199

    CAS  PubMed  Google Scholar 

  21. Margolis MT, Newton TH (1972) Borderlands of the normal and abnormal posterior inferior cerebellar artery. Acta Radiol Diagn 13:163–176

    CAS  Google Scholar 

  22. Margolis MT, Newton TH (1974) The posterior inferior cerebellar artery. In: Newton TH (ed) Radiology of the skull and brain: angiography. Mosby, St Louis, pp 1710–1744

  23. Matsushima T, Goto Y, Ishioka H, Mihara F, Fukui M (1999) Possible role of an endovascular provocative test in the diagnosis of glossopharyngeal neuralgia as a vascular compression syndrome. Acta Neurochir 141:1229–1232

    Article  CAS  Google Scholar 

  24. Osborn AG (1999) Diagnostic cerebral angiography. Lippincott, Philadelphia, pp 173–194

  25. Person H, Vallée B, Lefèvre C, Sénécail B (1998) Arterial and neural relations at the posterior and lateral aspects of the medullo-spinal junction. Surg Radiol Anat 20:177–184

    CAS  PubMed  Google Scholar 

  26. Pia HW (1979) Classification of vertebro-basilar aneurysms. Acta Neurochir 47:3–30

    CAS  Google Scholar 

  27. Rhoton AL Jr (1979) Microsurgical anatomy of the posterior fossa cranial nerves. Clin Neurosurg 26:398–462

    PubMed  Google Scholar 

  28. Rhoton AL Jr (1996) Comment to De Caro R, Parenti A, Munari PF. “Persistent primitive lateral vertebrobasilar anastomosis”. Acta Neurochir 138:594

    Google Scholar 

  29. Sadler TW (1990) Langman’s medical embryology. Williams & Wilkins, Baltimore 374–412

  30. Salmon G, Hung YP (1976) Radiologic anatomy of the brain. Springer, Berlin Heidelberg New York pp 305–306

  31. Stopford JSB (1916) The arteries of the pons and medulla oblongata. J Anat Physiol 50:131–164

    Google Scholar 

  32. Taha S, Segnarbieux F, Diaz A, Compeyre S, Nouges L (2000) Aneurysm of the postero-inferior cerebellar artery associated with arteriovenous malformation. Neurochirurgie 46:398–400

    CAS  PubMed  Google Scholar 

  33. Vallée B, Person H, Scarabin JM, Besson G, Mimassi N, Nguyen H (1982) Anatomie microchirurgicale du tronc de l’artère cérébelleuse postéro-inférieure. 22 microdissections. Neurochirurgie 28:383–389

    PubMed  Google Scholar 

  34. Williams PL, Bannister LH, Berry MM, Collins P, Dyson M, Dussek JE, Ferguson MWJ (1995) Gray’s Anatomy, 38th edn, Churchill Livingstone, London pp 242–243

Download references

Acknowledgments

The authors are grateful to Giuliano Carlesso for skillful technical assistance.

Author information

Authors and Affiliations

  1. Department of Human Anatomy and Physiology, Section of Anatomy, University of Padova, Via A Gabelli 65, 35121, Padova, Italy

    V. Macchi & R. De Caro

  2. Department of Environmental Medicine and Public Health, Section of Forensic Medicine, University of Padova, Via Falloppio 50, 35121, Padova, Italy

    A. Porzionato

  3. Department of Oncological and Surgical Sciences, Section of Pathologic Anatomy, University of Padova, Via A. Gabelli 61, 35121, Padova, Italy

    A. Parenti

Authors
  1. V. Macchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Porzionato
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Parenti
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. R. De Caro
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to R. De Caro.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Macchi, V., Porzionato, A., Parenti, A. et al. The course of the posterior inferior cerebellar artery may be related to its level of origin. Surg Radiol Anat 26, 60–65 (2004). https://doi.org/10.1007/s00276-003-0190-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00276-003-0190-2

Keywords

Search

Navigation