Surgical anatomy of the arteries of the posterior fossa

Journal of Neurosurgery
C ShrontzH G Mirchandani

Abstract

The development of revascularization for vertebrobasilar ischemic events has created a need to identify the best sites at which to perform bypass procedures. Since the occlusive process may selectively affect various levels of the vertebrobasilar tree, sites in different vessels must be used to reestablish flow distal to the area of occlusion. Twenty-seven unfixed human brains were obtained 4 to 8 hours post mortem, and the vertebrobasilar system was injected with polyester resin. Under a surgical microscope the outer diameter, length, and site of origin of major branches were recorded for the following arteries: vertebral, basilar, posterior inferior cerebellar (PICA), anterior inferior cerebellar (AICA), superior cerebellar (SCA), and posterior cerebral (PCA). The ideal sites for an anastomosis were identified as the pretonsillar segment of the PICA, the second portion of the AICA, the perimesencephalic segment of the SCA, and the perimesencephalic part of the PCA. Based on the anatomical observations reported here, these were the best sites because of their outer diameter, degree of mobility, least number of branches, and frequency of occurrence. Use of two of these arteries, however, may pose potential problems: although th...Continue Reading

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Citations

Oct 31, 1998·Neurosurgical Review·T NagataniJ Yoshida
Jun 22, 2005·European Radiology·Keng Yeow TayJonathan H Gillard
Jul 12, 2013·Anatomical Science International·Mugurel Constantin Rusu, Elena Pop
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Aug 26, 1998·Surgical and Radiologic Anatomy : SRA·H PersonB Sénécail

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