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Pica artery nerves12/19/2023 ![]() ![]() The dorsal medullary branch of PICA perfuses the posterior medulla. The vertebral artery supplies the posterior inferior cerebellar artery (PICA), which has 3 main branches: the dorsal, medial, and lateral medullary branches. The primary blood supply to the medulla comes from the vertebral arteries. These regions are divided based on their differing arterial supply. The medulla can be divided into 4 regions: anteromedial, anterolateral, lateral, and posterior ( Figure 1). This monograph highlights the neuro-ophthalmic presentations for the WS. WS is typically due to ischemia from a vertebral artery or posterior inferior cerebellar artery infarction. Wallenberg syndrome (WS) is a neurological disorder that is due to damage to the lateral portion of the medulla oblongata (i.e., the lateral medullary syndrome). 2.2 Systemic Manifestations (Table 1 ).Microsurgical anatomy of the veins of the posterior fossa. Matsushima T, Rhoton AL, de Oliveira E, Peace D. 3: clinical and interventional aspects in children. Lasjaunias P, ter Brugge KG, Berenstein A. Microsurgical anatomy of the posterior inferior cerebellar artery. ![]() Lister JR, Rhoton AL, Matsushima T, Peace DA. Anatomy, normal variations, and angiographic aspects. The lateral spinal artery of the upper cervical spinal cord. Lasjaunias P, Vallee B, Person H, Ter Brugge K, Chiu M. Microsurgical anatomy of the extracranial-extradural origin of the posterior inferior cerebellar artery. Developmental anatomy of the distal vertebral artery in relationship to variants of the posterior and lateral spinal arterial systems. Siclari F, Burger IM, Fasel JHD, Gailloud P. The posterior inferior cerebellar artery. Borderlands of the normal and abnormal posterior inferior cerebellar artery. Vallée B, Person H, Scarabin JM, Besson G, Mimassi N, Nguyen H. Interv Neuroradiol J Peritherapeutic Neuroradiol Surg Proced Relat Neurosci. Vascular microanatomy of the pontomedullary junction, posterior inferior cerebellar arteries, and the lateral spinal arteries. Mercier P, Brassier G, Fournier HD, Picquet J, Papon X, Lasjaunias P. Microsurgical relationships of the anterior inferior cerebellar artery and the facial-vestibulocochlear nerve complex. Martin RG, Grant JL, Peace D, Theiss C, Rhoton AL. Surface, structure, vascularization and three-dimensional section anatomy with MRI. The anterior inferior cerebellar artery: its variations, pontine distribution, and significance in the surgery of cerebello-pontine angle tumours. Syndrome of the posterior inferior and anterior cerebellar arteries and their branches. Clinical anatomy of the head: neurocranium, orbita, craniocervical regions. The surgical implications are discussed.Īmarenco P, Hauw JJ. All these veins terminate as bridging veins that we can divide in three groups: a superior group emptying into the great vein, a posterior group emptying into the transtentorial sinus, and a lateral group ending into the superior petrosal sinus. The deep veins refer to the veins transiting in the fissures between the cerebellum and the brainstem. The superficial veins drain the cerebellar cortex and transit on the surface of the cerebellum. Concerning the venous organization, we distinguish the superficial and deep veins. The PICA also can arise from a common trunk AICA-PICA and sometimes from the extradural segment of the vertebral artery. It can be sometimes doubled and rarely absent. The AICA can arise from a common trunk AICA-PICA. Concerning the SCA, its origin depends on the embryology. The main arterial variations involve essentially the origin of these vessels. The arterial vascularization of the cerebellum is based on three arteries which all originate from the vertebrobasilar system: the superior cerebellar artery (SCA), the anterior and inferior cerebellar artery (AICA), and the posterior and inferior cerebellar artery (PICA). We describe the vascular organization and the main variations through photographs of colored latex perfused brains, obtained with a surgical microscope. If the arterial vascularization of the cerebellum is well known, the main arterial variations and the whole venous vascularization are probably under recognized. Surgery of the posterior fossa represents a technical challenge because of the proximity of the vessels of the cerebellum. ![]()
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