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71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21.06. - 24.06.2020

Posterior inferior cerebellar artery with an extradural origin from the V3 segment – higher incidence on the nondominant vertebral artery

PICA mit extra-duralem Abgang aus dem V3 Segment

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  • presenting/speaker Muenyoshi Yasuda - Ichinomiyanishi Hospital, Neurological Surgery, Ichinomiya, Japan

Deutsche Gesellschaft für Neurochirurgie. 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. sine loco [digital], 21.-24.06.2020. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocP033

doi: 10.3205/20dgnc324, urn:nbn:de:0183-20dgnc3245

Published: June 26, 2020

© 2020 Yasuda.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at



Objective: The posterior inferior cerebellar artery (PICA) and the vertebral artery (VA) often show anatomical variations at the craniovertebral junction (CVJ). PICA originating extradurally from the V3 segment of the VA is one example, but its incidence and relationship to the VA and the atlas have not been discussed. This study evaluated the prevalence of PICAs originating from V3. We also analyzed other variations of the atlas and the VA.

Methods: We analyzed the computed tomography (CT) images from a series of 153 patients who underwent 3-dimensional CT angiography and investigated variations of the PICA, VA and atlas.

Results: Finally, 142 patients (284 sides) were analyzed and 11 patients (7.7%) were excluded due to poor image quality. The most common VA variation was PICA originating from V3. It was more frequently observed on the lesser VA than on the dominant VA (22.5% versus 6.25%; p=0.0005). The VA with PICA end was identified in 4 patients (1.41%); the incidence was the same as that observed in the persistent first intersegmental artery (1.41%). VA fenestration was only found in one patient (0.35%). Regarding the atlas, a ponticulus posticus (PP) was observed in 24 sides (6.0%). There was no relationship between the incidence of PP and the variations of the VA.

Conclusion: The PICA from V3 was the most common VA variation at the CVJ and was more frequent on the lesser VA. Surgeons should take care of this variation during operations.