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open access eISSN 2093-3673

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Case Report

Anat Cell Biol 2023; 56(3): 394-397

Published online September 30, 2023

https://doi.org/10.5115/acb.23.036

Copyright © Korean Association of ANATOMISTS.

An unusual arrangement between the highest denticulate ligament and posterior inferior cerebellar artery

Aditi Patel1 , Johnathan Baudoin2 , Arada Chaiyamoon3 , Juan J. Cardona4 , Ana Carrera5 , Francisco Reina5 , Joe Iwanaga4,6,7 , Aaron S. Dumont4 , R. Shane Tubbs1,4,6,7,8,9,10

1Department of Anatomical Sciences, St. George’s University, St. George’s, Grenada, 2Tulane School of Public Health & Tropical Medicine, Tulane School of Medicine, New Orleans, LA, USA, 3Department of Anatomy, Faculty of Medicine, Khon Kaen University, Thailand, 4Department of Neurosurgery, Tulane University School of Medicine, New Orleans, LA, USA, 5Department of Medical Sciences, Clinical Anatomy, Embryology and Neurosciences Research Group, University of Girona, Girona, Spain, 6Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, 7Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, 8Department of Surgery, Tulane University School of Medicine, New Orleans, LA, 9Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA, 10University of Queensland, Brisbane, Australia

Correspondence to:Arada Chaiyamoon
Department of Anatomy, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
E-mail: aradch@kku.ac.th

Received: February 3, 2023; Revised: March 14, 2023; Accepted: March 20, 2023

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The posterior inferior cerebellar artery (PICA) is often involved in pathologies of the posterior cranial fossa. Therefore, a good understanding of the vessel’s normal and variant courses is important to the neurosurgeon or neurointerventionalist. During the routine microdissection of the craniocervical junction, an unusual arrangement between the highest denticulate ligament and PICA was observed. On the right side, the PICA was given rise to by the V4 segment of the vertebral artery 9 mm after the artery entered the dura mater of the posterior cranial fossa. The artery made an acute turn around the lateral edge of the highest denticulate ligament to then recur 180 degrees and travel medially toward the brainstem. Invasive procedures that target the PICA should be aware of the variant as described herein.

Keywords: Artery, Posterior cranial fossa, Ligament, Vertebral artery, Aneurysms

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