Posterior inferior cerebellar artery

The posterior inferior cerebellar artery (PICA), the largest branch of the vertebral, is one of the three main arterial blood supplies for the cerebellum.

It winds backward around the upper part of the medulla oblongata, passing between the origins of the vagus and accessory nerves, over the inferior peduncle to the under surface of the cerebellum, where it divides into two branches.

The medial branch is continued backward to the notch between the two hemispheres of the cerebellum; while the lateral supplies the under surface of the cerebellum, as far as its lateral border, where it anastomoses with the anterior inferior cerebellar and the superior cerebellar branches of the basilar artery.

Branches from this artery supply the choroid plexus of the fourth ventricle.

Infarction of this artery due to thrombosis or stroke leads to PICA syndrome, a neurological disease with characteristic, stereotyped symptoms.

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