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Ana Rodríguez-Hernández, Albert L. Rhoton Jr. and Michael T. Lawton

; arterial dissections at the PICA-VA junction; arteriovenous malformations, which also commonly involve the other cerebellar arteries and the brainstem as well as the cerebellum; posterior fossa ischemia requiring bypass because of the PICA's easy accessibility through a suboccipital craniotomy and the proximity to the occipital artery; anomalies at the craniocervical junction, such as the Chiari malformation and osseous deformities; and dysfunction of the lower CNs such as glossopharyngeal neuralgia. The PICA can arise outside the dura, and at any point from along the