Intraoperative Visualization of Bilateral Thrombosis in the Posterior Inferior Cerebellar Artery Apparent in the Telovelomedullary Segment
(a) Intraoperative photograph, showing readily visible bilateral PICAs, after the removal of the tonsils. The arteries were pulseless, rigid, and dark. A seemingly calcified thrombus was visible in left PICA (arrow). The right thrombosed PICA was bluish (double arrow). C indicates cottonoid placed over the remaining occipital bone; C1: remaining parts of the C1 arch; Cr: cranial; Ca: caudal; L: left; R: right; S: suction. (b) Schematic drawing of the PICA. C indicates cerebellum; CaL: caudal loop of the PICA; CrL: cranial loop of the PICA; Hb: hemispheric branch; T: cerebellar tonsils, Ts: telovelomedullary segment; V: vermis; VA: vertebral artery; Vb: vermian branches.
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