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Davidoiu AM, Lazăr M, Vrapciu AD, Rădoi PM, Toader C, Rusu MC. An Update on the Superior Cerebellar Artery Origin Type. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2164. [PMID: 38138267 PMCID: PMC10744351 DOI: 10.3390/medicina59122164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/09/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: The microanatomy of the superior cerebellar artery (SCA) is clinically significant. We, thus, aimed at patterning unilateral and bilateral possibilities of SCA origin. Materials and Methods: In total, 205 archived records of computed tomography and magnetic resonance angiograms were used. There were defined types of SCA origin from the basilar artery (BA): "0"-absent SCA, "1"-preterminal, "2"-collateral SCA, with SCA appearing as a terminal branch of BA, and "3"-SCA from the posterior cerebral artery (PCA) of the cerebral type. Fenestrations and duplications of SCA were recorded. Bilateral combinations of types were recorded as follows: A (1 + 0), B (1 + 1), C (1 + 2), D (1 + 3), E (1 + duplicated SCA), F (2 + 2), G (2 + 3), H (3 + 3), I (3 + duplicated SCA), J (1 + fenestrated SCA). Results: Type 0 SCAs were found in 0.25%, type 1 in 71.29%, type 2 in 19.06%, and type 3 in 9.41%. Absent and fenestrated SCAs were each found in a single case. The most frequent combinations were B (58.05%), C (13.17%) and F (13.17%). Bilateral symmetrical types occurred in 70.7% of cases. Fetal types of PCA and the artery of Percheron modified the BA ends. Combinations of C, F, and G changed the BA ends or tips; thus, different subtypes resulted in five BA bifurcation patterns, including five BA trifurcations and one BA quadrifurcation. BA trifurcation was also found in cases with duplicated SCAs. Conclusions: The SCA has various anatomical possibilities of origin and bilateral combinations that are not presented in anatomical lectures. Details on the specific end of the BA should be gathered on a case-by-case basis.
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Affiliation(s)
- Ana-Maria Davidoiu
- Doctoral School, Faculty of Medicine, “Victor Babeş” University of Medicine and Pharmacy, RO-300041 Timișoara, Romania;
| | - Mihai Lazăr
- Department 2, Division of Physiopathology II, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, RO-020021 Bucharest, Romania;
| | - Alexandra Diana Vrapciu
- Department 1, Division of Anatomy, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, RO-020021 Bucharest, Romania
| | - Petrinel Mugurel Rădoi
- Department 6–Clinical Neurosciences, Division of Neurosurgery, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, RO-020021 Bucharest, Romania; (P.M.R.); (C.T.)
- Clinic of Neurosurgery, “Dr. Bagdasar-Arseni” Emergency Clinical Hospital, RO-041915 Bucharest, Romania
| | - Corneliu Toader
- Department 6–Clinical Neurosciences, Division of Neurosurgery, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, RO-020021 Bucharest, Romania; (P.M.R.); (C.T.)
- Clinic of Neurosurgery, “Dr. Bagdasar-Arseni” Emergency Clinical Hospital, RO-041915 Bucharest, Romania
| | - Mugurel Constantin Rusu
- Department 1, Division of Anatomy, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, RO-020021 Bucharest, Romania
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Garcia-Gonzalez U, Cavalcanti DD, Agrawal A, Spetzler RF, Preul MC. Anatomical Study on the “Perforator-free Zone”: Reconsidering the Proximal Superior Cerebellar Artery and Basilar Artery Perforators. Neurosurgery 2011; 70:764-72; discussion 771-2. [DOI: 10.1227/neu.0b013e3182351f8e] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
Background:
The proximal superior cerebellar artery (pSCA) is often considered a perforator-free area. Precise anatomical knowledge of this region clarifies the pathophysiology underlying posterior fossa ischemic syndromes and helps avoid treatment-related complications.
Objective:
To anatomically evaluate perforating branches arising from the pSCA and the upper basilar artery (BA).
Methods:
Forty-four SCAs from 20 cadaveric heads were examined to determine patterns of the pSCA; its morphometry for medial and lateral branches; and frequency, number, diameter, distribution, and vascular territory of perforators arising from the pSCA and rostral BA.
Results:
SCA arose as a single trunk in 36 sides (90%): mean diameter at origin was 1.38 mm; mean length was 14.± 6 7.9 mm. Ninety-nine pSCA perforator branches were present in 82% of specimens (mean, 2.3 ± 1.6; range, 0-7 perforators/side). Of these, 59% were direct, belonging to the interpeduncular group in 85% of cases; 28% were short circumflex, belonging to lateral and medial pontine group; and 13% were long circumflex, reaching the medullary perforation zone (basal cerebellar group). Median distance to the first perforator was 2.0 mm (range, 0.1–15 mm). There were 132 perforator branches in the last centimeter of the BA.
Conclusion:
The pSCA should not be regarded as a perforator-free area. Although the pSCA territories likely overlap with the posterior cerebral artery, BA, and anterior inferior cerebellar artery, the pSCA segment cannot be surgically manipulated with impunity.
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Affiliation(s)
- Ulises Garcia-Gonzalez
- Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Daniel D. Cavalcanti
- Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Abhishek Agrawal
- Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Robert F. Spetzler
- Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Mark C. Preul
- Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
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Ouattara-Doumbia M, Le Moing AG, Bourel-Ponchel E, Delignières A, Schauvliege J, de Broca A, Chabrol B, Berquin P. [Infratentorial ischemic stroke in children: Three case reports]. Arch Pediatr 2011; 18:544-9. [PMID: 21458968 DOI: 10.1016/j.arcped.2011.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2009] [Revised: 03/13/2010] [Accepted: 02/15/2011] [Indexed: 11/26/2022]
Abstract
Ischemic stroke is rare in children, most of which occur in the supratentorial brain, and infratentorial infarcts are very rare. Some clinical manifestations may be similar but others such as ataxia and cranial nerve palsy are more specific. Vertebral artery dissection is the most frequent cause of stroke in the vertebrobasilar territory, but the cause most often remains unknown in children. We report three cases of infratentorial stroke in children. The first observation concerns a 4-year-old boy brought to medical attention because left hemicorporal motor deficit associated with ataxia following a minor cranial traumatism. While computed tomography (CT) of the brain was normal, magnetic resonance imaging (MRI) revealed an area of signal alteration on the diffusion-weighted image within the right protuberance. The second observation is a 15-year-old girl who developed sudden-onset ataxia. The CT scan and MRI of the brain revealed an acute bilateral cerebellar stroke. MRI angiography showed an anatomical variant of the left vertebral artery that did not participate in the Willis polygon. In these two observations, no other abnormalities were detected except they were homozygotous for MTHFR mutation in the first observation and minor alpha-thalassemia for the second one. The outcome in these two children was good without sequelae after a 6-month follow-up. The third observation is a 6-year-old girl who suddenly exhibited cephalalgia, ataxia, and left visual impairment. The brain MRI revealed left occipital and cerebellar strokes due to vertebral artery dissection. The authors recommend the systematic search for vertebral artery dissection in cases of infratentorial stroke.
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Affiliation(s)
- M Ouattara-Doumbia
- Service de neuropédiatrie, CHU Amiens-Nord, place Victor-Pauchet, 80054 Amiens cedex 1, France
| | - A-G Le Moing
- Service de neuropédiatrie, CHU Amiens-Nord, place Victor-Pauchet, 80054 Amiens cedex 1, France; Service de neuropédiatrie, hôpital de la Timone-Marseille, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
| | - E Bourel-Ponchel
- Service de neuropédiatrie, CHU Amiens-Nord, place Victor-Pauchet, 80054 Amiens cedex 1, France
| | - A Delignières
- Service de neuropédiatrie, CHU Amiens-Nord, place Victor-Pauchet, 80054 Amiens cedex 1, France
| | - J Schauvliege
- Service de neuroradiologie, CHU Amiens-Nord, place Victor-Pauchet, 80054 Amiens cedex 1, France
| | - A de Broca
- Service de neuropédiatrie, CHU Amiens-Nord, place Victor-Pauchet, 80054 Amiens cedex 1, France
| | - B Chabrol
- Service de neuropédiatrie, hôpital de la Timone-Marseille, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
| | - P Berquin
- Service de neuropédiatrie, CHU Amiens-Nord, place Victor-Pauchet, 80054 Amiens cedex 1, France
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Martin-Vaquero P, da Costa RC, Echandi RL, Tosti CL, Knopp MV, Sammet S. Time-of-flight magnetic resonance angiography of the canine brain at 3.0 Tesla and 7.0 Tesla. Am J Vet Res 2011; 72:350-6. [PMID: 21355738 DOI: 10.2460/ajvr.72.3.350] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the ability of 2-D time-of-flight (ToF) magnetic resonance angiography (MRA) to depict intracranial vasculature and compare results obtained with 3.0- and 7.0-T scanners in dogs. ANIMALS 5 healthy Beagles. PROCEDURES 2-D ToF-MRA of the intracranial vasculature was obtained for each dog by use of a 3.0-T and a 7.0-T scanner. Quantitative assessment of the images was obtained by documentation of the visibility of major arteries comprising the cerebral arterial circle and their branches and recording the number of vessels visualized in the dorsal third of the brain. Qualitative assessment was established by evaluation of overall image quality and image artifacts. RESULTS Use of 3.0- and 7.0-T scanners allowed visualization of the larger vessels of the cerebral arterial circle. Use of a 7.0-T scanner was superior to use of a 3.0-T scanner in depiction of the first- and second-order arterial branches. Maximum-intensity projection images had a larger number of vessels when obtained by use of a 7.0-T scanner than with a 3.0-T scanner. Overall, image quality and artifacts were similar with both scanners. CONCLUSIONS AND CLINICAL RELEVANCE Visualization of the major intracranial arteries was comparable with 3.0- and 7.0-T scanners; the 7.0-T scanner was superior for visualizing smaller vessels. Results indicated that ToF-MRA is an easily performed imaging technique that can be included as part of a standard magnetic resonance imaging examination and should be included in the imaging protocol of dogs suspected of having cerebrovascular disease.
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Affiliation(s)
- Paula Martin-Vaquero
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210, USA
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Spalice A, Del Balzo F, Perla FM, Properzi E, Carducci C, Antonozzi I, Iannetti P. Methylenetetrahydrofolate reductase homozygous mutation in a young boy with cerebellar infarction. Pediatr Rep 2009; 1:e4. [PMID: 21589820 PMCID: PMC3096031 DOI: 10.4081/pr.2009.e4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2009] [Revised: 10/01/2009] [Accepted: 10/01/2009] [Indexed: 12/04/2022] Open
Abstract
Posterior circulation vascular occlusive disease in children is a rare and uncommonly reported event. Among the numerous risk factors, the methylenetetrahydrofolate reductase (MTHFR) mutation is considered to be a common genetic cause of thrombosis in adults and children. Recently, a link between the MTHFR mutation and cerebrovascular disorders was reported in children. Diffusion tensor imaging (DTI) is a great improvement on magnetic resonance imaging (MRI), making the in vivo anatomical and pathological study of the brain and its fibers possible. In our patient cerebellar infarction was associated with MTHFR mutation and, in a standard neurological examination, DTI revealed normal white matter tracts.
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