It is the fourth segment of VA that gives off the PICA, which is the largest branch of VA. The first three segments were extracranial and the fourth segment is entirely intracranial and terminates with forming the basilar artery (BA). The VA, arising from the subclavian artery, is classically divided into 4 segments. The posterior inferior cerebellar artery (PICA) usually originates from the vertebral artery (VA) at an average distance of approximately 16 or 17 mm below the vertebrobasilar junction. Keywords: posterior inferior cerebellar artery, clinical importance, anatomy, aneurysms Introduction In conclusion, PICA is very important in clinical practice. The PICA can be exposed and injured during surgeries especially in telovelar approach, and it also plays an important role in bypass surgeries, hinting the surgical importance of PICA. The PICA supplies many brain tumors and can be used in intracerebellar chemotherapy. VA terminating in PICA probably cause Bow hunter's syndrome (BHS). PICA injured by head trauma can cause fatal SAH. Arteriovenous malformation (AVM) fed by PICA are associated with aneurysm and dissection which have high risk of rupture and worse outcome. The PICA frequently compresses the medulla and the cranial nerves resulting in various neurovascular compression syndromes (NVCS). The PICA infarct typically manifests lateral medullary syndrome (LMS) and is more likely to cause mass effects. Various aneurysms involving PICA were not uncommon, of which the treatment is challenging. The PICA has tortuous and variable course and territory, divided into 5 segments. In this study, we perform a literature review of PICA by searching all the associated papers in the PUBMED database hoping to provide a better understanding of the artery. However, a comprehensive systematic review of the importance of the PICA is currently lacking. The posterior inferior cerebellar artery (PICA), with its unique anatomical complexity, is of great clinical importance and involved in many diseases including aneurysm, ischemic stroke, neurovascular compression syndrome (NVCS), arteriovenous malformation (AVM), and brain tumor. Select the file that you have just downloaded and select import option Reference Manager (RIS). Available fromĬlick on Go to download the file. Clinical Importance of the Posterior Inferior Cerebellar Artery: A Review of the Literature. Posterior inferior cerebellar artery 에 의한 stroke 시에 오는 Horner's syndrome, dysphagia, dysarthris 는 오지 않는다.Miao HL, Zhang DY, Wang T, Jiao XT, Jiao LQ. 이경우 gaze palsy, deafness, tinnitus, ipsilateral facial weakness 가 있다. 진찰상 left facial paralysis 와 left side 에 poor hearing 이 있었다. It can be caused by an interruption to the blood supply of the anterior inferior cerebellar artery. A lateral pontine syndrome is a lesion which is similar to the lateral medullary syndrome, but because it occurs in the pons, it also involves the cranial nerve nuclei of the pons. There is also loss of pain and temperature sensation from the contralateral limbs and trunk, which can lead to diagnostic confusion with lateral medullary syndrome, which also gives rise to "crossed" neurological signs but does not normally cause cochlear symptoms, severe facial palsy or multimodal facial sensory loss. The symptoms include sudden onset of vertigo and vomiting, nystagmus, dysarthria, falling to the side of the lesion (due to damage to vestibular nuclei), and a variety of ipsilateral features including hemiataxia, loss of all modalities of sensation of the face (due to damage to the principal sensory trigeminal nucleus), facial paralysis (due to damage to the facial nucleus), and hearing loss and tinnitus (due to damage to the cochlear nuclei). Occlusion of AICA is considered rare, but generally results in a lateral pontine syndrome, also known as AICA syndrome. The amount of tissue supplied by the AICA is variable, depending upon whether the PICA is more or less dominant, but usually includes the anteroinferior surface of the cerebellum, the flocculus, middle cerebellar peduncle and inferolateral portion of the pons. It also gives off the internal auditory or labyrinthine artery in most cases however, the labyrinthine artery can less commonly emerge as a branch of the basilar artery. It has a variable course, passing backward to be distributed to the anterior part of the undersurface of the cerebellum, anastomosing with both the posterior inferior cerebellar (PICA) branch of the vertebral artery and the superior cerebellar artery. It arises from the basilar artery on each side at the level of the junction between the medulla oblongata and the pons in the brainstem. The anterior inferior cerebellar artery (AICA) is one of three pairs of arteries that supplies blood to the cerebellum.
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