Saylam C, Ucerler H, Orhan M, Cagli S, Zileli M
Department of Anatomy, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey.
Clin Anat. 2007 Nov;20(8):886-91. doi: 10.1002/ca.20541.
The posterior inferior cerebellar artery (PICA) is the largest branch of the vertebral artery. It usually arises at the anterolateral margin of the medulla oblongata close to the lower cranial nerves. The PICA had the most complex relationship to the cranial nerves of any artery and it is frequently exposed in approaches directed to the fourth ventricle. The aim of this article is to describe the anatomical relationship of the PICA to the lower cranial nerves. In this study, 12.5% of PICAs passed between the glossopharyngeal and vagus nerves, 20% between the vagus and accessory nerves, and 65% through the rootlets of the accessory nerve. The lateral medullary segment of the PICA showed a lateral loop which in 20% specimens pressed against the inferior surfaces of the facial and vestibulocochlear nerves. The lateral medullary segment of the PICA in 20% specimens passed superior to the hypoglossal nerve, in 47.5% through the rootlets of the hypoglossal nerve, and in 30% inferior to the hypoglossal nerve. The findings on the relationship of the PICA to the lower cranial nerves could be helpful in microsurgery of this region.
小脑后下动脉（PICA）是椎动脉最大的分支。它通常起源于延髓前外侧缘，靠近下颅神经。PICA与任何动脉的颅神经关系最为复杂，并且在通向第四脑室的手术入路中经常暴露。本文的目的是描述PICA与下颅神经的解剖关系。在本研究中，12.5%的PICA在舌咽神经和迷走神经之间通过，20%在迷走神经和副神经之间通过，65%通过副神经的根丝。PICA的延髓外侧段显示一个外侧袢，在20%的标本中该袢压迫面神经和前庭蜗神经的下表面。20%标本中PICA的延髓外侧段走行于舌下神经上方，47.5%通过舌下神经的根丝，30%走行于舌下神经下方。PICA与下颅神经关系的这些发现可能有助于该区域的显微手术。
