Microsurgical anatomy of the posterior circulation.
BACKGROUND
The microsurgical anatomy of the posterior circulation is very complex and variable. Surgical approaches to this area are considered risky due to the presence of the various important blood vessels and neural structures.


OBJECTIVE
To document the microsurgical anatomy of the posterior circulation along with variations in the Indian population.


METHODS
The authors studied 25 cadaveric brain specimens. Microsurgical dissection was carried out from the vertebral arteries to the basilar artery and its branches, the basilar artery bifurcation, posterior cerebral artery and its various branches. Measurements of the outer diameters of the vertebral artery, basilar artery and posterior cerebral artery and their lengths were taken.


RESULTS
The mean diameter of the vertebral artery was 3.4 mm on the left and 2.9 mm on the right. The diameter of the basilar artery varied from 3-7 mm (mean of 4.3 mm). The length varied from 24-35 mm (mean of 24.9 mm). The basilar artery gave off paramedian and circumferential perforating arteries. The origin of the anterior inferior cerebellar artery (AICA) varied from 0-21 mm (mean 10.0 mm) from the vertebrobasilar junction. The diameter of the AICA varied from being hypoplastic i.e.,


CONCLUSIONS
The authors have documented the various anomalies as well as the differences of the anatomy in this area in the Indian population as compared to the Western literature.
Pai
Balaji S
BS
Department of Neurosurgery, MS Ramaiah Medical College, Bangalore - 560 085, India. balajipai65@yahoo.co.in
Varma
Ravi G
RG
Kulkarni
Raghavendra N
RN
Nirmala
S
S
Manjunath
L C
LC
Rakshith
S
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001488:Basilar Artery / Q000033:anatomy & histology*; D001921:Brain / Q000033:anatomy & histology*; D002102:Cadaver; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D020769:Posterior Cerebral Artery / Q000033:anatomy & histology*; D014711:Vertebral Artery / Q000033:anatomy & histology*