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Bihemispheric posterior inferior cerebellar artery in a cadaver with Chiari I malformation
- Department of Neurosurgery, Tulane Centre for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, United States
- Tulane University and Ochsner Clinic Neurosurgery Programme, Tulane University School of Medicine, New Orleans LA, United States
- Department of Anatomical Dissection and Donation, Medical University of Lodz, Poland
- Department of Neurosurgery, Tulane Centre for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, United States
- Department of Neurology, Tulane University School of Medicine, New Orleans, LA, United States
- Department of Neurosurgery, Ochsner Health System, New Orleans, LA, United States
- Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, LA, United States
- Department of Anatomical Sciences, St. George’s University, St. George’s, Grenada, West Indies
- Department of Surgery, Tulane University School of Medicine, New Orleans, LA, United States
- University of Queensland, Brisbane, Australia
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Abstract
Typically, patients with Chiari I malformations (CM I) do not have other intracranial anatomical variations, especially vascular derailments. Here, we report the findings of a cadaveric specimen found to have CM I and cerebellar tonsils supplied by
a single posterior inferior cerebellar artery (PICA) i.e., a bihemispheric PICA. An adult male cadaver was found to have CM I. It was also noted that the left PICA descended inferiorly to the level of C1 and that there was absence of the right PICA. The territory of the right PICA was supplied by the left PICA. The tonsillar component of the left PICA gave rise to a branch that crossed to the right inferior cerebellum and herniated cerebellar tonsil. A bihemispheric PICA is very rare. To our knowledge, this is the first report of this vascular variation in combination with CM I. Such a variation should be kept in mind, especially during posterior fossa decompression for symptomatic CM I as unilateral PICA injury could have catastrophic results.
Abstract
Typically, patients with Chiari I malformations (CM I) do not have other intracranial anatomical variations, especially vascular derailments. Here, we report the findings of a cadaveric specimen found to have CM I and cerebellar tonsils supplied by
a single posterior inferior cerebellar artery (PICA) i.e., a bihemispheric PICA. An adult male cadaver was found to have CM I. It was also noted that the left PICA descended inferiorly to the level of C1 and that there was absence of the right PICA. The territory of the right PICA was supplied by the left PICA. The tonsillar component of the left PICA gave rise to a branch that crossed to the right inferior cerebellum and herniated cerebellar tonsil. A bihemispheric PICA is very rare. To our knowledge, this is the first report of this vascular variation in combination with CM I. Such a variation should be kept in mind, especially during posterior fossa decompression for symptomatic CM I as unilateral PICA injury could have catastrophic results.
Keywords
hindbrain herniation, vertebrobasilar system, posterior cranial fossa, tonsillar ectopia, variation
Title
Bihemispheric posterior inferior cerebellar artery in a cadaver with Chiari I malformation
Journal
Issue
Article type
Case report
Pages
375-381
Published online
2022-04-05
Page views
2219
Article views/downloads
825
DOI
Pubmed
Bibliographic record
Folia Morphol 2023;82(2):375-381.
Keywords
hindbrain herniation
vertebrobasilar system
posterior cranial fossa
tonsillar ectopia
variation
Authors
N. Boggio
M. Mathkour
Ł. Olewnik
J. Iwanaga
C. J. Bui
E. E Biro
R. S. Tubbs
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