Anatomy and Cell Biology

Korean Association of Anatomists (대한해부학회)
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An unusual arrangement between the highest denticulate ligament and posterior inferior cerebellar artery

  • Aditi Patel (Department of Anatomical Sciences, St. George's University) ;
  • Johnathan Baudoin (Tulane School of Public Health & Tropical Medicine, Tulane School of Medicine) ;
  • Arada Chaiyamoon (Department of Anatomy, Faculty of Medicine, Khon Kaen University) ;
  • Juan J. Cardona (Department of Neurosurgery, Tulane University School of Medicine) ;
  • Ana Carrera (Department of Medical Sciences, Clinical Anatomy, Embryology and Neurosciences Research Group, University of Girona) ;
  • Francisco Reina (Department of Medical Sciences, Clinical Anatomy, Embryology and Neurosciences Research Group, University of Girona) ;
  • Joe Iwanaga (Department of Neurosurgery, Tulane University School of Medicine) ;
  • Aaron S. Dumont (Department of Neurosurgery, Tulane University School of Medicine) ;
  • R. Shane Tubbs (Department of Anatomical Sciences, St. George's University)
  • Received : 2023.02.03
  • Accepted : 2023.03.20
  • Published : 2023.09.30
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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

Acknowledgement

The authors sincerely thank those who donated their bodies to science so that anatomical research could be performed. Results from such research can potentially increase mankind's overall knowledge that can then improve patient care. Therefore, these donors and their families deserve our highest gratitude [8].

References

  1. Polak-Krasna K, Robak-Nawrocka S, Szotek S, Czyz M, Gheek D, Pezowicz C. The denticulate ligament - tensile characterisation and finite element micro-scale model of the structure stabilising spinal cord. J Mech Behav Biomed Mater 2019;91:10-7. 
  2. Tubbs RS, Mortazavi MM, Loukas M, Shoja MM, Cohen-Gadol AA. The intracranial denticulate ligament: anatomical study with neurosurgical significance. J Neurosurg 2011;114:454-7. 
  3. Iwanaga J, Singh V, Takeda S, Ogeng'o J, Kim HJ, Morys J, Ravi KS, Ribatti D, Trainor PA, Sanudo JR, Apaydin N, Sharma A, Smith HF, Walocha JA, Hegazy AMS, Duparc F, Paulsen F, Del Sol M, Adds P, Louryan S, Fazan VPS, Boddeti RK, Tubbs RS. Standardized statement for the ethical use of human cadaveric tissues in anatomy research papers: recommendations from Anatomical Journal Editors-in-Chief. Clin Anat 2022;35:526-8. 
  4. Lister JR, Rhoton AL Jr, Matsushima T, Peace DA. Microsurgical anatomy of the posterior inferior cerebellar artery. Neurosurgery 1982;10:170-99. 
  5. Miao HL, Zhang DY, Wang T, Jiao XT, Jiao LQ. Clinical importance of the posterior inferior cerebellar artery: a review of the literature. Int J Med Sci 2020;17:3005-19. 
  6. Ballesteros-Acuna LE, Estupinan HY, Gomez-Torres FA. Morphologic characterisation of the posterior inferior cerebellar artery. A direct anatomic study. Folia Morphol (Warsz) 2022;81:559-66. 
  7. Park JS, Lee TH, Seo EK, Cho YJ. Aneurysms of distal posterior inferior cerebellar artery. J Korean Neurosurg Soc 2008;44:205-10. 
  8. Iwanaga J, Singh V, Ohtsuka A, Hwang Y, Kim HJ, Morys J, Ravi KS, Ribatti D, Trainor PA, Sanudo JR, Apaydin N, Sengul G, Albertine KH, Walocha JA, Loukas M, Duparc F, Paulsen F, Del Sol M, Adds P, Hegazy A, Tubbs RS. Acknowledging the use of human cadaveric tissues in research papers: recommendations from anatomical journal editors. Clin Anat 2021;34:2-4.