Vertebral artery terminating in posterior inferior cerebellar artery: A normal variation with clinical significance
نویسندگان
چکیده
A vertebral artery (VA) terminating in a posterior inferior cerebellar artery (PICA) is often considered to be a normal variation associated with VA hypoplasia. We aimed to investigate the clinical significance of this cerebrovascular variant. A total of 80 patients with clinically evident cerebrovascular events in posterior circulation were examined by duplex sonography and magnetic resonance angiography (MRA). Eighty healthy subjects who had MRA check-up were recruited as controls. PICA termination of the VA (PICA-VA) was identified as the VA not communicating with the basilar artery (BA) but ending into a PICA. We compared the prevalence of PICA-VA and associated hemodynamic parameters between the patients with and without PICA-VA, and investigated their relationships with VA hypoplasia. The prevalence of PICA-VA was higher in the patient group than in the controls (18.7% vs. 6.3%, p = 0.015). Most measurements (73.3%) of PICA-VA did not fit the criteria of VA hypoplasia. In comparison with the non-PICA-terminating group, the PICA-VA has a smaller diameter (3.7 ± 0.7 mm vs. 3.0 ± 0.5 mm, p < 0.001), lower mean velocity (241 ± 100 mm/sec vs. 164 ± 88 mm/sec, p < 0.01), and higher pulsatility index (1.3 ± 0.5 vs. 1.9 ± 0.6, p < 0.001). Moreover, a smaller diameter of the BA (3.2 ± 0.5 mm vs. 2.5 ± 0.9 mm, p = 0.004) and the posterior cerebral artery (PCA) (2.0 ± 0.1 mm vs. 1.6 ± 0.1 mm, p = 0.006) were also noted in the PICA-VA group. The higher prevalence of PICA-VA in the patient group with smaller diameter of VA, BA and PCA reflected its clinical significance, suggesting that PICA-VA may have a detrimental impact on cerebral hemodynamics. However, the sample is small, and further studies are needed with larger sample size for confirmation.
منابع مشابه
Vertebrobasilar ischemia after neck motion.
BACKGROUND Vertebrobasilar ischemic strokes may occur after chiropractic manipulation of the cervical spine or, less often, after spontaneous and abrupt head movement. SUMMARY OF REVIEW We describe three such cases of vertebrobasilar ischemic strokes and review 36 other reported cases. CONCLUSIONS We give evidence that 1) the population at risk cannot be identified a priori in the vast majo...
متن کاملRare Variation in the Right Vertebral Artery
The variations of vertebral artery are important with regard to their potential clinical impact .The study reports the variation of course of right vertebral artery in male cadaver. The vertebral arteries arise from the superioposterior aspect of the first part of subclavian artery. The vessel takes a vertical course to enter into the transverse foramen of sixth cervical vertebra. Right vertebr...
متن کاملVascular anomaly at the craniocervical junction presenting with sub arachnoid hemorrhage: Dilemma in Imaging Diagnosis, Endovascular Management and Complications.
We present a case of a ruptured vertebral artery dissecting aneurysm that mimicked a presumed vascular anomaly by CTA (Computerized Tomographic Angiography). A parenchymal arteriovenous malformation (AVM) or a dural arteriovenous fistula (DAVF) at the craniocervical junction can present with a subarachnoid hemorrhage and cannot be differentiated from a vertebral artery dissection by non invasiv...
متن کاملAneurysm of the distal posterior inferior cerebellar artery originating from extracranial fenestrated vertebral artery.
متن کامل
Anomalous origin of the posterior inferior cerebellar artery from the posterior meningeal artery.
The posterior inferior cerebellar artery (PICA) usually originates from the distal vertebral artery . Many variations in its origin and course have been observed in association with anomalies of the anterior inferior cerebellar artery (AICA) (1 ). However, as far as we know, angiographic evidence of anomalous origin of the PICA from the posterior meningeal artery (PMA) has not been reported pre...
متن کامل