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Table of Contents
CASE REPORT
Year : 2015  |  Volume : 2  |  Issue : 1  |  Page : 158-159

Unilateral triplication of superior cerebellar artery associated with fetal posterior cerebral artery: Case report


1 Marco Zenteno, MD, Professor de terapia endovascular neurológica, Departamento de Terapia Endovascular Neurológica, Instituto Nacional de Neurología y Neurocirugía, Universidad Nacional Autónoma de México; Unidad Vascular, Hospital Ángeles del Pedregal, Cartagena de Indias, Colombia
2 Luis Rafael Moscote-Salazar, MD, Universidad de Cartagena, Cartagena de Indias, Colombia
3 Hernando Raphael Alvis-Miranda, MD, Universidad de Cartagena, Cartagena de Indias, Colombia
4 Alejandro Rojas, MD, Departamento de Terapia endovascular neurológica, Instituto Nacional de Neurologíay Neurocirugía; Universidad Nacional Autónoma de , UNAM, DF, México
5 Ángel Lee, MD, Department of Neurosurgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán; Unidadd Vascular cerebral, Hospital Ángeles del Pedregal, DF, Mexico

Date of Web Publication4-Jul-2017

Correspondence Address:
L R Moscote-Salazar
Universidad de Cartagena, Cartagena de Indias
Colombia
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Source of Support: None, Conflict of Interest: None


DOI: 10.5530/ami.2015.1.27

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  Abstract 


Introduction: Superior cerebellar artery is the most constant among the cerebellar arteries and is almost always present, sometimes it can be double, and more rarely, triple. Methods: We report the case of a 72-yr male patient who came to hospital in whom cerebral angiography was performed because of subarachnoid hemorrhage. Results: cerebral angiography showed the unusual presence of an embryonic right posterior cerebral artery, associated with triplication of the right superior cerebellar artery. Conclusion: The tripling of the SCA is seen in only 7% of angiographic abnormalities and rarely is associated with posterior communicating artery aneurysms and embryonic posterior cerebral artery, as in our case.

Keywords: Angiographic abnormalities, Cerebellar arteries, Superior cerebellar artery


How to cite this article:
Zenteno M, Moscote-Salazar L R, Alvis-Miranda H R, Rojas A, Lee A. Unilateral triplication of superior cerebellar artery associated with fetal posterior cerebral artery: Case report. Acta Med Int 2015;2:158-9

How to cite this URL:
Zenteno M, Moscote-Salazar L R, Alvis-Miranda H R, Rojas A, Lee A. Unilateral triplication of superior cerebellar artery associated with fetal posterior cerebral artery: Case report. Acta Med Int [serial online] 2015 [cited 2020 Nov 27];2:158-9. Available from: https://www.actamedicainternational.com/text.asp?2015/2/1/158/209438




  Introduction Top


Superior cerebellar artery (SCA) is the most constant among the cerebellar arteries and is almost always present; is the most rostral of all infratentorial vessels, arises as a unique trunk, a few millimeters proximal to the origin of the posterior cerebral arteries, which divides into superior and inferior branches. The SCA can sometimes be double, and more rarely, triple.[12]


  Case Report Top


We present the case of a male patient, 72-years-old, who was brought by family members to the emergency department of our institution because of intense holocraneal cephalea. On physical examination, vital signs were stable, however stiff neck was present, so was decided to perform brain-TC scan revealing subarachnoid hemorrhage probably from aneurismal origin, prompting to perform cerebral angiography, showing an aneurysm in the posterior communicating artery, during the procedure was evidenced as unusual anatomical variant, the presence of an embryonic right posterior cerebral artery, associated with triplication of the right SCA. [Figure 1] Syngo iFlow sequence was obtained, confirming the unusual anatomical variant.
Figure 1: Cerebral angiography of the vertebrobasilar axis in the early arterial phase, showing a right SCA triplication.

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Figure 2: Syngo iFlow of the vertebrobasilar axis in the early arterial phase, showing a right SCA triplication.

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  Discussion Top


Diverse anatomical variants have been described regard to SCA, such as extraordinary origins, duplication and more rarely triplication.[1],[2] Embriologically, SCA surges from superior segment that ends in the bifurcation site of the basilar artery, when it divides into the posterior cerebral arteries (rostral edge bifurcation). The mean diameter of SCA is of 4.2 mm, with an average from 4.1 mm to 4.6 mm.[3]

Frequently, SCA originates from the basilar apex, but directly adjacent to the origin of the posterior cerebral arteries. SCA is subdivided into four segments: anterior ponto-mesencephalic segment, lateral ponto-mesencephalic segment, the cerebelomesencephalic segment and cortical segment. All SCA segments are anatomically related to cranial nerves III, IV and V.[3],[4]

Several variants of the SCA have been described, also with diverse points of origin, such as a single trunk and less frequently as double trunk. The most common is the origin in the segment P of the posterior cerebral artery. SCA is the most consistent artery in the posterior circulation in terms of origin and location, so the basilar artery bifurcation is an important determinant of the initial course of SCA.[5],[6]

The tripling of the SCA is seen in only 7% of angiographic abnormalities and rarely is associated with posterior communicating artery aneurysms and embryonic posterior cerebral artery, as in our case.



 
  References Top

1.
Hardy, D. G., & Rhoton, A. L. Microsurgical relationships of the superior cerebellar artery and the trigeminal nerve. J Neurosurg, 1978;49(5): 669–78. doi:10.3171/jns.1978;49(5):0669.  Back to cited text no. 1
    
2.
Mani, R., Newton, T., & Glickmann, M. The superior cerebellar artery: an anatomical roentgenographic correlation. Radiology,1968; 91:1102.  Back to cited text no. 2
    
3.
Padget, D. The development of the cranial arteries in the human embryo. Contrib Embryol Carnegie Inst, 1948;32: 205–261.  Back to cited text no. 3
    
4.
Rhoton, A. J. The cerebellar arteries. In A. J. Rhoton (Ed.), Cranial anatomy and surgical approaches Schaumberg: Lippincott Williams and Wilkins,2003;pp:461–500.  Back to cited text no. 4
    
5.
Seckin, H., Kazanci, A., Men, S., & Zafer Kars, H. Bilateral duplication of superior cerebellar artery associated with fetal posterior cerebral artery: case presentation. Turkish Neurosurgery, 2002;(12): 140–141.  Back to cited text no. 5
    
6.
Tsutsumi, M., Kazekawa, K., Tanaka, A., Ueno, Y., & Nomoto, Y. Duplication of distal part of the basilar artery. Radiat Med., Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12450107,2002; 20(5):265–7.  Back to cited text no. 6
    


    Figures

  [Figure 1], [Figure 2]



 

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