Double posterior inferior cerebellar artery

Abstract

Posterior inferior cerebellar artery (PICA) is one of the cerebellar arteries which originates from the vertebral artery and has the most complex and variable course. It usually originates from the vertebral artery intracranially and as a single trunk; however, absent, double trunk, extracranial, and extradural PICA may exists although very rare. In a collection of 50 cerebellar specimens (100 hemispheres) injected with colored gelatin, we have encountered unilateral double PICA in 2 specimens. In both the cases (both male, aged 45 and 65 years) double trunks of PICA were observed on the right side. Double-trunk PICA may signal an improved blood supply to the corresponding cerebellar hemisphere; however, the second trunk, which may also be called an accessory trunk, is usually smaller than the first (main) trunk of PICA.

Clinical Importance of the Posterior Inferior Cerebellar Artery: A Review of the Literature

“…If one PICA is hypoplastic or absent, the ipsilateral anterior inferior cerebellar artery (AICA) or the contralateral PICA is larger and supplies the area normally nourished by the ipsilateral PICA 10 . Duplication of the PICA occurs in 2 - 6% of hemispheres 1 , 10 , 15 . Double origin of the PICA is a rare variation different from duplication, in those cases two distinct PICAs with separate origins converge distally.…”

Treatment of dissecting aneurysms of the PICA: Anatomical considerations and clinical outcome

“…In more distally located aneurysms with very tortuous anatomy flow dependent micro-catheters were used to be as gentle as possible during navigation and prevent rebleeding. The development of ischemia-related neurological deficits depends highly on the local vascular PICA anatomy and the presence of collaterals, such as the AICA, SCA, the contralateral PICA or even a double origin PICA [15,16]. In only two patients collateral flow was visible prior to treatment.…”

Bihemispheric posterior inferior cerebellar artery in a cadaver with Chiari I malformation

“…For example, in 2.8-7% of reported cases, the vertebral artery continued as the [31]. A duplicated origin of the PICA (two distinct arteries without convergence) has been observed in 2-6% of hemispheres [16,23,36], and a double origin (two distinct origins with distal convergence) in approximately 1.45% of cases [22]. A fenestrated PICA is very rare, occurring in only about 0.3% of cases (Pekcevik and Pekcevik, 2014 [31]).…”