Absent right PICA
Citation, DOI and case data
Suspected cerebral infarction.
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No evidence of recent infarction or hemorrhage (CT brain not shown).
Incidentally noted absence of right posterior inferior cerebellar artery (PICA). Well-developed left PICA.
Unilateral absence of the PICA is common 1,2. The differential diagnosis for an absent PICA is PICA occlusion and a hypoplastic PICA. In this specific case, there was no clinical suspicion nor imaging evidence of a PICA territory cerebellar infarction (PICA occlusion), nor was there any sign of origin of the artery (hypoplastic PICA). A sign that strengthens the diagnosis of an absent PICA is the well-developed contralateral PICA 1. If the rest of the PICA's course is visible (see PICA -Segments), look for an anomalous origin - it may originate from the basilar artery 2.
- 1. Miao HL, Zhang DY, Wang T, Jiao XT, Jiao LQ. Clinical Importance of the Posterior Inferior Cerebellar Artery: A Review of the Literature. (2020) International journal of medical sciences. 17 (18): 3005-3019. doi:10.7150/ijms.49137 - Pubmed
- 2. Akgun V, Battal B, Bozkurt Y, Oz O, Hamcan S, Sari S, Akgun H. Normal Anatomical Features and Variations of the Vertebrobasilar Circulation and Its Branches: An Analysis with 64-Detector Row CT and 3T MR Angiographies. (2013) The Scientific World Journal. doi:https://doi.org/10.1155/2013/620162