Vascular Microanatomy of the Pontomedullary Junction,Posterior Inferior Cerebellar Arteries,and the Lateral Spinal Arteries

Abstract

This study of 25 brains at the pontomedullary junction defined the different possible origins of the perforating arteries and lateral spinal arteries in relation to the posterior inferior cerebellar arteries (PICAs).

- If the PICA emerges from the common trunk of the AICA-PICA coming from the basilar artery, it never gives perforating arteries or a lateral spinal artery on the lateral surface of the brain stem but supplies blood to a part of the ipsilateral cerebellar hemisphere.

- If the PICA arises extradurally at C1, it never gives perforating arteries for the lateral surface of the brain stem, but it gives pial branches for the posterior surface of the medulla oblongata and is always the origin of the lateral spinal artery.

- If the PICA emerges in the intradural vertebral artery, it is the source of the perforating arteries for the lateral surface of the brain stem and of the blood supply of the ipsilateral cerebellum.

Keywords

medulla oblongata posterior inferior cerebellar artery (PICA)perforating arteries lateral spinal artery

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References

Akar

Dujovny

: Microvascular anatomy of the anterior surface of the medulla oblongata and olive. J Neurosurg 82: 97–105, 1995.

Amarenco

Hauw

: Anatomie des artères cérébelleuses. Rev Neurol. (Paris) 145, 4: 267–276, 1989.

Ariens Kappers

: Anatomie comparée du système nerveux. Paris, Masson et Cie, 524–532, 1947.

Duvernoy

: Human Brainstem Vessels, Springer-Verlag, Berlin Heidelberg New York 1978.

Grand

Budny

: Microvascular surgical anatomy of the vertebrobasilar junction. Neurosurg 40, 6: 1219–1225, 1997.

Lasjaunias

Vallee

: The lateral spinal artery of the upper cervical spinal cord. J Neurosurg 63: 235–241, 1985.

Lasjaunias

Berenstein

terBrugge

: Surgical Neuroangiography, vol 1, 2nd ed

Springer-Verlag

2003, 224–260.

Lister

Rhoton

Jr : Microsurgical anatomy of the posterior inferior cerebellar artery. Neurosurg, 10, 2: 170–199, 1982.

Mahmood

Dujovny

: Microvascular anatomy of foramen caecum medullae oblongata. J Neurosurg 75: 299–304, 1991.

10.

Maillot

Koritke

: Les origines du tronc artériel spinal postérieur chez l'homme. CR Assoc Anat 149: 837–847, 1970.

11.

Marinkovic

Gibo

: The surgical anatomy of the perforating branches of the basilar artery. Neurosurgery, 33, 1: 80–87, 1993.

12.

Marinkovic

Gibo

Milisavljevic

: The surgical anatomy of the relationships between the perforating and the leptomeningeal arteries. Neurosurg. 39, 1: 72–83, 1996.

13.

Mercier

Brassier

: Predictability of the cervical origin of the anterior spinal artery. Interventional Neuroradiology 3: 283–288, 1997.

14.

Mercier

Brassier

: Is the foramen caecum the uppermost part of the spinal medulla? Interventional Neuroradiology 5: 307–312, 1999.

15.

Stopford

JSB

: The arteries of the pons and medulla oblongata. J Anat Physiol 50: 131–164, 1916.

16.

Vallee

Person

: Anatomie microchirurgicale du tronc de l'artère cérébelleuse postéro-inférieure. Neurochirugie 28: 383–389, 1982.

17.

Yasargil

: Microneurosurgery, Stuttgart, Georg Thieme Verlag, 1984, Vol 1 and 2.