Ota Takahiro, Dofuku Shogo, Sato Masayuki
Department of Neurosurgery, Tokyo Metropolitan Tama Medical Center, Fuchu, Tokyo, Japan.
NMC Case Rep J. 2022 Apr 1;9:69-72. doi: 10.2176/jns-nmc.2021-0386. eCollection 2022.
Posterior inferior cerebellar artery (PICA) variations are well recognized; however, their mechanisms have not been well understood. Primitive lateral basilovertebral anastomosis (PLBA) was described in 1948 by Padget and is one of the embryological transient longitudinal channels in the hindbrain. This study reports a PICA aneurysm associated with PLBA. A 48-year-old man presented with subarachnoid hemorrhage. Cerebral angiography showed a 3.6-mm fusiform aneurysm with a bleb of the left PICA just at the origin of the PICA from the vertebral artery. Furthermore, a direct anterior inferior cerebellar artery (AICA)-PICA anastomosis parallel to the basilar artery was revealed. This direct anastomosis between the AICA and PICA is explained by the partial persistence of PLBA. Variations in the three cerebellar arteries and vertebrobasilar junction can be caused by persistence of PLBA.
小脑后下动脉（PICA）变异已广为人知；然而，其机制尚未得到充分理解。原始外侧基底椎动脉吻合（PLBA）由帕吉特于1948年描述，是后脑胚胎期的短暂纵向通道之一。本研究报告了一例与PLBA相关的PICA动脉瘤。一名48岁男性出现蛛网膜下腔出血。脑血管造影显示一个3.6毫米的梭形动脉瘤，在左侧PICA从椎动脉发出处有一个小泡。此外，还发现了一条与基底动脉平行的直接小脑前下动脉（AICA）-PICA吻合。AICA与PICA之间的这种直接吻合可通过PLBA的部分残留来解释。PLBA的残留可导致三条小脑动脉和椎基底交界处的变异。
