Vascular Anatomy of the Cerebellum

The blood supply of the cerebellum is provided by the vertebrobasilar arterial system. The three major branches are the posterior inferior cerebellar artery (PICA), the anterior inferior cerebellar artery (AICA), and the superior cerebellar artery (SCA). The PICA usually arises from the vertebral artery, the AICA from the basilar artery, and the SCA from the basilar artery before its bifurcation into the posterior cerebral arteries. Variations in the size and distribution of these vessels are frequent, and all major branches are highly anastomotic. All cerebellar arteries supply cerebellar as well as brain stem structures. Therefore, vascular disorders usually damage the cerebellum and brain stem together.

Branches of the PICA supply the inferior aspect of the cerebellar hemispheres extending up to the primary fissure, the cortex of the inferior vermis, the deep cerebellar nuclei as well as the inferior cerebellar peduncle, the lateral medulla oblongata, and the choroid plexus of the fourth ventricle. Branches of the AICA supply the flocculus and adjacent lobules of the inferior and anterior cerebellum, the inferior and middle cerebellar peduncles as well as the nuclei of cranial nerves VII to Ix and XII in the brain stem and the inner ear (the internal auditory artery and the labyrinthine artery). The SCA supplies the superior parts of the cerebellar hemispheres, major parts of the vermis, all deep cerebellar nuclei, and all cerebellar peduncles, as well as the pons ( ...Fig 1,7.z4 ). [19]

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