Double Origin of the Posterior Inferior Cerebellar Artery: Association with Intracranial Aneurysm on Catheter Angiography

Abstract

Our data show that double origin of the PICA is seen in 4.1% of patients with intracranial aneurysm and on 1.45% of catheter angiograms. Double origin of the PICA has an increased association with intracranial aneurysmal disease and may represent a risk factor for subsequent development of intracranial aneurysm.

Double origin of the superior cerebellar artery associated with homolateral haemorrhagic infarction of cerebellum

“…The PICA, instead, is the most variable. PICAs with double origin have previously been reported in the literature both in angiography [1,3,[10][11][12]14,15,[19][20][21]29] and autopsy [22,32]. Fenestrations of the PICA have also been reported in few case reports [16,23] and contemporary presence of double origin and fenestration of one of the two components has been reported only twice [1,12].…”

“…The double origin of the PICA has been ascribed to persistence of anastomosis of PICA with the lateral spinal artery. In particular, the lateral spinal artery would become the caudal component of the double origin of the PICA while the rostral component would represent the PICA proper, embryologically derived from a hypertrophied radiculopial artery [11,14,15,21]. Some authors proposed that PICA fenestrations could result from partial regression of double origins [16].…”

“…Previous studies have reported the association of intracranial aneurysms with fenestrations and double origins of the posterior inferior cerebellar artery [1,14,15]. Aneurysms have been reported near the double origin of PICA or far away from the anatomical variation.…”

“…In some cases, aneurysms have been specifically reported in the cranial or caudal channels of a double origin of PICA [9,10,13,19,20,29] or in the PICA after convergence of the two channels [9]. In particular, it has been suggested that double origin of the PICA could represent the effect of an underlying disorganization of the vascular development, which increases the risk of acquired intracranial aneurysms [15]. Some authors also recommended that a thorough search for intracranial aneurysms should be performed if a double origin of PICA is detected [21].…”

Comment on Bilateral Anomalous Posterior Inferior Cerebellar Artery-Anterior Inferior Cerebellar Artery Anastomotic Arteries Associate with a Ruptured Cerebral Aneurysm

“…Siclari F and Lesly WS described unique studies of PICA origin and variant. Named PICA-AICA anastomotic arteries associate with C1 origin of PICAs similar to double origin of PICA [1][2][3].…”