Features of the cerebellar vascular supply (review)

Abstract

Ischemic and hemorrhagic strokes remain the most devastating diseases of cerebrovascular system. They may cause disorders of speech, memory, mental health or movement. However, stroke can be prevented. Knowledge of the vascularization of the cerebellum and its variations is important for choosing a strategy of prevention and effective treatment of stroke. This review will discuss the variant anatomy of three pairs of cerebellar arteries: superior cerebellar artery (SCA), anterior inferior cerebellar artery (AICA) and posterior inferior cerebellar artery (PICA). In most cases SCA and AICA arise from basilar artery, PICA arises from vertebral artery. SCA supplies tentorial cerebellar surface and dentate nucleus, AICA – petrosal surface of the cerebellum, flocculus, tegmentum, pons and middle cerebellar peduncles, PICA – suboccipital surface of the cerebellum, tonsil, inferior vermis, fastigial nucleus, choroid plexus and medulla. We conclude that SCA is the most constant artery and PICA is the most variable one. SCA can originate from the junction of the first segment of posterior cerebral artery and basilar artery or directly from the first segment of posterior cerebral artery. AICA can arise from vertebral artery or from common trunk with PICA. Rarely AICA arise from PICA. PICA can originate from basilar artery, extradural part of vertebral artery (C1-C2 or even C2-C3), ascending pharyngeal artery, proatlantal artery, ascending cervical artery or rarely from internal carotid artery. Many analyzed studies showed that PICA can be absent more often than AICA; SCA is almost always present. SCA is also duplicated more than other cerebellar arteries (mostly on the left). Significant difference was found in different studies about frequency of duplication of the AICA. PICA is rarely duplicated. Territories of cerebellar arteries change depending on their origin, course and also on the absence or duplication of the other ones. Many studies showed that SCA, AICA or PICA can dominate and send their branches to the territories of the other arteries which are absent or hypoplastic. The present study also describes classifications of segments of the cerebellar arteries, types of cerebellar vascular supply and superficial vascular network. Keywords: human, cerebellum, superior cerebellar artery, anterior inferior cerebellar artery, posterior inferior cerebellar artery.