Posterior inferior cerebellar artery originating from a limb of intracranial vertebral artery fenestration: a Computed Tomography Angiography and Magnetic Resonance Angiography study.

IF 1.4 4区医学 Q2 Medicine

Surgical and Radiologic Anatomy Pub Date : 2025-04-30 DOI:10.1007/s00276-025-03641-9

Marialuisa Zedde, Rosario Pascarella

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引用次数: 0

Abstract

Purpose: We aimed to describe a rare case of a posterior cerebral artery (PIC) dual origin from a vertebral artery (VA) fenestration and to propose a detailed embryological reasoning on this anomaly. Among the anomalies of intracranial arteries, fenestrations are not uncommon and they may be associated with aneurysms and arterio-venous malformations. The VA is one of the most frequent locations for fenestrations, being more common in extracranial that in intracranial segment and due to different embryological mechanisms. Moreover, among the cerebellar arteries, the posterior-inferior cerebellar artery (PICA) demonstrates the greatest anatomical variability regarding its origin, course, and branching pattern. In some cases, the differentiation between fenestrations and duplications is quite subtle.

Methods: We are presenting the case of an association of anomalies with a huge fenestration of the V4 VA and PICA originating from one of the limbs of the fenestration. This was an incidental finding during a computed tomography angiography (CTA) performed because of sudden headache. The anatomical and embryological features of this finding are discussed in detail.

Conclusions: The reported anomaly may have different names (fenestration vs duplication) and different embryological origins among the persisting primitive anastomoses pertaining to the lateral spinal artery or posterior spinal artery systems.

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起源于颅内椎动脉开窗一肢的小脑后下动脉：计算机断层血管造影和磁共振血管造影的研究。

目的：我们的目的是描述一个罕见的情况下，大脑后动脉（PIC）双起源的椎动脉（VA）开窗，并提出详细的胚胎学推理的这种异常。在颅内动脉异常中，开窗并不罕见，它可能与动脉瘤和动静脉畸形有关。由于不同的胚胎机制，VA是最常见的开孔位置之一，在颅外比颅内段更常见。此外，在小脑动脉中，小脑后下动脉（PICA）在其起源、路线和分支模式方面表现出最大的解剖学变异性。在某些情况下，开窗和重复之间的区别是相当微妙的。方法：我们提出的情况下，异常与一个巨大的开窗的V4 VA和异食癖起源于开窗的一个肢体。这是一个偶然发现，在计算机断层血管造影（CTA）进行，因为突然头痛。详细讨论了这一发现的解剖学和胚胎学特征。结论：在脊髓外侧动脉或脊髓后动脉系统持续存在的原始吻合口中，报告的异常可能有不同的名称（开窗或重复）和不同的胚胎起源。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgical and Radiologic Anatomy Medicine-Pathology and Forensic Medicine

CiteScore

2.40

自引率

14.30%

发文量

期刊介绍： Anatomy is a morphological science which cannot fail to interest the clinician. The practical application of anatomical research to clinical problems necessitates special adaptation and selectivity in choosing from numerous international works. Although there is a tendency to believe that meaningful advances in anatomy are unlikely, constant revision is necessary. Surgical and Radiologic Anatomy, the first international journal of Clinical anatomy has been created in this spirit. Its goal is to serve clinicians, regardless of speciality-physicians, surgeons, radiologists or other specialists-as an indispensable aid with which they can improve their knowledge of anatomy. Each issue includes: Original papers, review articles, articles on the anatomical bases of medical, surgical and radiological techniques, articles of normal radiologic anatomy, brief reviews of anatomical publications of clinical interest. Particular attention is given to high quality illustrations, which are indispensable for a better understanding of anatomical problems. Surgical and Radiologic Anatomy is a journal written by anatomists for clinicians with a special interest in anatomy.