Int J Med Sci 2020; 17(18):3005-3019. doi:10.7150/ijms.49137 This issue


Clinical Importance of the Posterior Inferior Cerebellar Artery: A Review of the Literature

Hui-Lei Miao1,3*, Deng-Yan Zhang1,2*, Tao Wang1*, Xiao-Tian Jiao1, Li-Qun Jiao1✉

1. Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, No. 45, Changchun Street, Beijing 100032, China.
2. School of General Practice and Continuing Education, Capital Medical University, Beijing 100069,China
3. Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China.
* These authors contributed equally.

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Miao HL, Zhang DY, Wang T, Jiao XT, Jiao LQ. Clinical Importance of the Posterior Inferior Cerebellar Artery: A Review of the Literature. Int J Med Sci 2020; 17(18):3005-3019. doi:10.7150/ijms.49137. Available from

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The posterior inferior cerebellar artery (PICA), with its unique anatomical complexity, is of great clinical importance and involved in many diseases including aneurysm, ischemic stroke, neurovascular compression syndrome (NVCS), arteriovenous malformation (AVM), and brain tumor. However, a comprehensive systematic review of the importance of the PICA is currently lacking. In this study, we perform a literature review of PICA by searching all the associated papers in the PUBMED database hoping to provide a better understanding of the artery. The PICA has tortuous and variable course and territory, divided into 5 segments. Various aneurysms involving PICA were not uncommon, of which the treatment is challenging. The PICA infarct typically manifests lateral medullary syndrome (LMS) and is more likely to cause mass effects. The PICA frequently compresses the medulla and the cranial nerves resulting in various neurovascular compression syndromes (NVCS). Arteriovenous malformation (AVM) fed by PICA are associated with aneurysm and dissection which have high risk of rupture and worse outcome. PICA injured by head trauma can cause fatal SAH. VA terminating in PICA probably cause Bow hunter's syndrome (BHS). The PICA supplies many brain tumors and can be used in intracerebellar chemotherapy. The PICA can be exposed and injured during surgeries especially in telovelar approach, and it also plays an important role in bypass surgeries, hinting the surgical importance of PICA. In conclusion, PICA is very important in clinical practice.

Keywords: posterior inferior cerebellar artery, clinical importance, anatomy, aneurysms