The anatomy of the superior cerebellar artery: a detailed analysis

BACKGROUND: The superior cerebellar artery (SCA) represents the most rostral branch of the vertebrobasilar circulation. A thorough understanding of the anatomy of the SCA and its surrounding structures is essential for the safe and effective performance of surgical procedures addressing compression syndromes, aneurysms, and ischemic infarctions. The aim of the study was to evaluate the anatomical variability of the SCA in the material from Central European individuals in order to refine and supplement the existing literature. MATERIALS AND METHODS: Computed tomography angiography results from 96 patients (188 hemifaces) were analyzed. Each artery was assessed in terms of morphometric parameters and existing anatomical classifications. RESULTS: In 15 cases, a duplicated SCA was observed. The most frequent origin of the SCA was from the basilar artery, observed in 92.12% of cases. Significantly fewer SCAs originated from the posterior cerebral artery (PCA) (4.93%) or from a short common trunk (2.96%). Origin from the basilar artery was more common on the right side (96.97%) than the left (87.50%) (p = 0.01). The median diameter at the origin was 2.36 mm (range: 1.01-3.41 mm), with a median cross-sectional area of 3.35 mm². The median length of the SCA was 23.39 mm, extending up to 44.08 mm. CONCLUSIONS: The current study provides a comprehensive anatomical and morphometric analysis of the SCA, highlighting its origin, morphological variations, and clinical significance. The findings confirm that while the SCA most commonly arises from the basilar artery, notable side- and sex-dependent variations exist, particularly in terms of origin types ana morphological parameters. Significant differences in vessel dimensions and cross-sectional areas were observed between sexes, with some age-related correlations identified in males. These anatomical nuances may have direct clinical implications, particularly in neurovascular compression syndromes and the management of aneurysms. Understanding the diverse configurations of the SCA is essential for accurate diagnosis and safe surgical intervention.