Considerations regarding the morphological variability of the superior cerebellar artery.

PURPOSE: The superior cerebellar artery (SCA) is a critical vascular structure supplying the cerebellum and brainstem. Despite its anatomical importance, variations in its origin and morphology remain underreported. This study aims to systematically assess the origin and morphological variations of the SCA using computed tomography angiography (CTA) in a large retrospective cohort.

METHODS

A total of 500 CTA brain scans (1,000 SCAs) were retrospectively analyzed. The study categorized the SCA based on its origin into five types and its morphology into five distinct patterns.

RESULTS

The most common SCA origin was from the distal basilar artery (BA) (65.3%), followed by a common trunk with the posterior cerebral artery (PCA) at the BA tip (24.5%) and an origin from the PCA (9.6%). A rare case of SCA arising from a fetal-type PCA (0.1%) was identified. Morphologically, the typical SCA pattern was observed in 92.9% of cases, while 7.1% exhibited variations. The most frequent morphological variant was complete duplication (4.7%), followed by early bifurcation (1.3%), fenestration (0.8%), and double origin (0.3%). No significant correlations were found between SCA variability and sex or laterality.

CONCLUSIONS

This study provides a comprehensive classification system for SCA origin and morphology. Given the clinical relevance of these variations in neurosurgical and neurointerventional procedures, a thorough understanding of SCA anatomy is essential. The findings contribute to improved diagnostic accuracy and surgical planning, highlighting the need for precise imaging-based assessment of cerebrovascular anatomy.