Segmental anatomy of cerebellar arteries: a proposed nomenclature

Laboratory investigation

View More View Less
  • 1 Department of Neurological Surgery, University of California, San Francisco, California; and
  • 2 Department of Neurological Surgery, University of Florida, Gainesville, Florida
Restricted access

Purchase Now

USD  $45.00

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $505.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00
Print or Print + Online

Object

The conceptual division of intracranial arteries into segments provides a better understanding of their courses and a useful working vocabulary. Segmental anatomy of cerebral arteries is commonly cited by a numerical nomenclature, but an analogous nomenclature for cerebellar arteries has not been described. In this report, the microsurgical anatomy of the cerebellar arteries is reviewed, and a numbering system for cerebellar arteries is proposed.

Methods

Cerebellar arteries were designated by the first letter of the artery's name in lowercase letters, distinguishing them from cerebral arteries with the same first letter of the artery's name. Segmental anatomy was numbered in ascending order from proximal to distal segments.

Results

The superior cerebellar artery was divided into 4 segments: s1, anterior pontomesencephalic segment; s2, lateral pontomesencephalic segment; s3, cerebellomesencephalic segment; and s4, cortical segment. The anterior inferior cerebellar artery was divided into 4 segments: a1, anterior pontine segment; a2, lateral pontine segment; a3, flocculopeduncular segment; and a4, cortical segment. The posterior inferior cerebellar artery was divided into 5 segments: p1, anterior medullary segment; p2, lateral medullary segment; p3, tonsillomedullary segment; p4, telovelotonsillar segment; and p5, cortical segment.

Conclusions

The proposed nomenclature for segmental anatomy of cerebellar artery complements established nomenclature for segmental anatomy of cerebral arteries. This nomenclature is simple, easy to learn, and practical. The nomenclature localizes distal cerebellar artery aneurysms and also localizes an anastomosis or describes a graft's connections to donor and recipient arteries. These applications of the proposed nomenclature with cerebellar arteries mimic the applications of the established nomenclature with cerebral arteries.

Abbreviations used in this paper: ACA = anterior cerebral artery; AICA = anterior inferior cerebellar artery; CN = cranial nerve; MCA = middle cerebral artery; PCA = posterior cerebral artery; PICA = posterior inferior cerebellar artery; SCA = superior cerebellar artery; STA = superficial temporal artery; VA = vertebral artery.

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $505.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00

Contributor Notes

Address correspondence to: Michael T. Lawton, M.D., Department of Neurological Surgery, University of California, San Francisco, 505 Parnassus Avenue, M780, San Francisco, California 94143-0112. email: lawtonm@neurosurg.ucsf.edu.

Please include this information when citing this paper: published online May 6, 2011; DOI: 10.3171/2011.3.JNS101413.

  • 1

    Argenson C, , Francke JP, , Sylla S, , Dintimille H, , Papasian S, & di Marino V: The vertebral arteries (segments V1 and V2). Anat Clin 2:2941, 1980

    • Search Google Scholar
    • Export Citation
  • 2

    Bruneau M, , Cornelius JF, & George B: Anterolateral approach to the V1 segment of the vertebral artery. Neurosurgery 58:4 Suppl 2 ONS-215ONS-219, 2006

    • Search Google Scholar
    • Export Citation
  • 3

    Bruneau M, , Cornelius JF, & George B: Anterolateral approach to the V2 segment of the vertebral artery. Neurosurgery 57:4 Suppl 262267, 2005

    • Search Google Scholar
    • Export Citation
  • 4

    Bruneau M, , Cornelius JF, & George B: Antero-lateral approach to the V3 segment of the vertebral artery. Neurosurgery 58:1 Suppl ONS29ONS35, 2006

    • Search Google Scholar
    • Export Citation
  • 5

    George B, & Cornelius J: Vertebral artery: surgical anatomy. Oper Tech Neurosurg 4:168181, 2001

  • 6

    Gibo H, , Carver CC, , Rhoton AL Jr, , Lenkey C, & Mitchell RJ: Microsurgical anatomy of the middle cerebral artery. J Neurosurg 54:151169, 1981

    • Search Google Scholar
    • Export Citation
  • 7

    Gibo H, , Lenkey C, & Rhoton AL Jr: Microsurgical anatomy of the supraclinoid portion of the internal carotid artery. J Neurosurg 55:560574, 1981

    • Search Google Scholar
    • Export Citation
  • 8

    Hardy DG, , Peace DA, & Rhoton AL Jr: Microsurgical anatomy of the superior cerebellar artery. Neurosurgery 6:1028, 1980

  • 9

    Hardy DG, & Rhoton AL Jr: Microsurgical relationships of the superior cerebellar artery and the trigeminal nerve. J Neurosurg 49:669678, 1978

    • Search Google Scholar
    • Export Citation
  • 10

    Lawton MT, , Quinones-Hinojosa A, & Jun P: The supratonsillar approach to the inferior cerebellar peduncle: anatomy, surgical technique, and clinical application to cavernous malformations. Neurosurgery 59:4 Suppl 2 ONS244ONS252, 2006

    • Search Google Scholar
    • Export Citation
  • 11

    Lawton MT, & Spetzler RF: Surgical strategies for giant intracranial aneurysms. Acta Neurochir Suppl (Wien) 72:141156, 1999

  • 12

    Lister JR, , Rhoton AL Jr, , Matsushima T, & Peace DA: Microsurgical anatomy of the posterior inferior cerebellar artery. Neurosurgery 10:170199, 1982

    • Search Google Scholar
    • Export Citation
  • 13

    Martin RG, , Grant JL, , Peace DA, , Theiss C, & Rhoton AL Jr: Microsurgical relationships of the anterior inferior cerebellar artery and the facial-vestibulocochlear nerve complex. Neurosurgery 6:483507, 1980

    • Search Google Scholar
    • Export Citation
  • 14

    Paullus WS, , Pait TG, & Rhoton AI Jr: Microsurgical exposure of the petrous portion of the carotid artery. J Neurosurg 47:713726, 1977

  • 15

    Perlmutter D, & Rhoton AL Jr: Microsurgical anatomy of the anterior cerebral-anterior communicating-recurrent artery complex. J Neurosurg 45:259272, 1976

    • Search Google Scholar
    • Export Citation
  • 16

    Perlmutter D, & Rhoton AL Jr: Microsurgical anatomy of the distal anterior cerebral artery. J Neurosurg 49:204228, 1978

  • 17

    Rhoton AL Jr: Aneurysms. Neurosurgery 51:4 Suppl S121S158, 2002

  • 18

    Rhoton AL Jr: The cerebellar arteries. Neurosurgery 47:3 Suppl S29S68, 2000

  • 19

    Rhoton AL Jr: The cerebellopontine angle and posterior fossa cranial nerves by the retrosigmoid approach. Neurosurgery 47:3 Suppl S93S129, 2000

    • Search Google Scholar
    • Export Citation
  • 20

    Rhoton AL Jr: The supratentorial arteries. Neurosurgery 51:4 Suppl S53S120, 2002

  • 21

    Rhoton AL Jr, Microsurgical anatomy of posterior fossa cranial nerves. Barrow DL: Surgery of the Cranial Nerves of the Posterior Fossa: Neurosurgical Topics Chicago, AANS, 1103, 1993

    • Search Google Scholar
    • Export Citation
  • 22

    Rhoton AL Jr, , Fujii K, & Fradd B: Microsurgical anatomy of the anterior choroidal artery. Surg Neurol 12:171187, 1979

  • 23

    Rosner SS, , Rhoton AL Jr, , Ono M, & Barry M: Microsurgical anatomy of the anterior perforating arteries. J Neurosurg 61:468485, 1984

  • 24

    Saeki N, & Rhoton AL Jr: Microsurgical anatomy of the upper basilar artery and the posterior circle of Willis. J Neurosurg 46:563578, 1977

    • Search Google Scholar
    • Export Citation
  • 25

    Sanai N, , Tarapore P, , Lee AC, & Lawton MT: The current role of microsurgery for posterior circulation aneurysms: a selective approach in the endovascular era. Neurosurgery 62:12361253, 2008

    • Search Google Scholar
    • Export Citation
  • 26

    Sanai N, , Zador Z, & Lawton MT: Bypass surgery for complex brain aneurysms: an assessment of intracranial-intracranial bypass. Neurosurgery 65:670683, 2009

    • Search Google Scholar
    • Export Citation
  • 27

    Sanchez-Mejia RO, & Lawton MT: Distal aneurysms of basilar perforating and circumferential arteries. Report of three cases. J Neurosurg 107:654659, 2007

    • Search Google Scholar
    • Export Citation
  • 28

    Zador Z, , Lu DC, , Arnold CM, & Lawton MT: Deep bypasses to the distal posterior circulation: anatomical and clinical comparison of pretemporal and subtemporal approaches. Neurosurgery 66:92101, 2010

    • Search Google Scholar
    • Export Citation
  • 29

    Zeal AA, & Rhoton AL Jr: Microsurgical anatomy of the posterior cerebral artery. J Neurosurg 48:534559, 1978

Metrics

All Time Past Year Past 30 Days
Abstract Views 3604 2132 210
Full Text Views 1228 427 32
PDF Downloads 495 200 8
EPUB Downloads 0 0 0