Bihemispheric posterior inferior cerebellar artery occurring with an azygos anterior cerebral artery: case study.

Jamie Toms,Hugo Cuellar,Sudheer Ambekar,Rishi Wadhwa

doi:10.1155/2014/541081

Abstract

Variations in intracranial vasculature are well known. We report a rare anatomic variation in a patient who underwent cerebral angiography for suspected intracranial aneurysm. Digital subtraction angiography revealed a bihemispheric posterior inferior cerebellar artery (PICA) and an azygous anterior cerebral artery (ACA). There was no evidence of any aneurysm or vascular abnormality. To our knowledge, this is the first reported case of a patient with a common PICA supplying both the cerebellar hemispheres and a common ACA supplying ACA territory bilaterally. It is important for the physician to be aware of these anatomical variations in order to differentiate a normal variant from a pathological condition.

Highlights

Anatomical variations are patterns that deviate from the normal anatomical arrangement in the absence of functional impairment
The understanding of such variation is of the utmost importance when the vascular supply to the central nervous system is concerned
A single enlarged bihemispheric posterior inferior cerebellar artery (PICA) can supply territory in both hemispheres of the cerebellum [5, 6]. Another neurovascular abnormality, where a single artery supplies both sides of the brain [8], is the azygos anterior cerebral artery (ACA)

Summary

Introduction

Anatomical variations are patterns that deviate from the normal anatomical arrangement in the absence of functional impairment. A single enlarged bihemispheric PICA can supply territory in both hemispheres of the cerebellum [5, 6] Another neurovascular abnormality, where a single artery supplies both sides of the brain [8], is the azygos anterior cerebral artery (ACA). This occurs in only 0.1–0.5% of patients, when there is a fusion between the A2 segments of the right and left ACA and a single vessel supplies both cerebral hemispheres [3, 5, 9].

Case Study

Discussion

Findings

Conclusion