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Related to cerebellar artery: basilar artery
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The suboccipital middle keyhole approach can expose the cerebellar tonsil and inferior vermis, posterior inferior cerebellar artery, the fourth ventricle, pons and medullary dorsal parts.
The Saltzman type I PTA joins the basilar artery at the level between superior cerebellar artery (SCA) and anterior inferior cerebellar artery (AICA).
The 6th nerve thus turns superiorly on entering the sub-arachnoid space, where it passes immediately above the anterior inferior cerebellar artery.
Aneurysm site: ICA internal carotid artery, ACA and MCA are anterior and middle cerebral arteries, PICA posterior inferior cerebellar artery, and ACoA is the anterior communicating artery.
Arteriolar damage occurs characteristically in the lenticulostriate arteries of the middle cerebral artery and the posterior cerebral artery, the penetrating branches of the basilar artery, and the central cerebellar artery.
The right posterior inferior cerebellar artery (PICA) was not well seen and was thought to be compressed by surrounding hemorrhage, involved with vasospasm or thrombosed.
Serious complications such as laceration of the cerebellar artery by sub-occipital puncture of the cisterna magna, may ensue if the direction of the needle is inappropriate.
The common offending vessels are anterior inferior cerebellar artery (AICA) and posterior inferior cerebellar artery (PICA).
The most common offending vessel is the posteroinferior cerebellar artery (PICA), followed by the vertebral artery, the anteroinferior cerebellar artery (AICA), and other vessels or combinations of vessels.
Branches of the basilar artery, the anterior inferior cerebellar artery, and the superior cerebellar artery supply the lateral pons and the cerebellum.
Neither examination was reviewed by a neuroradiologist until an intraoperative consult was given, at which time a correct diagnosis of giant posterior-inferior cerebellar artery (PICA) aneurysm was made.