A Superior View of the Vertebral Artery within the Skull

Description

Seen from a superior intracranial perspective, the paired vertebral arteries ascend through the foramen magnum at the anterolateral margins of the medulla and converge on the midline to form the basilar artery along the ventral surface of the pons. Lateral branches consistent with the posterior inferior cerebellar arteries (PICA) can be inferred near the caudal cerebellum, while the basilar apex gives rise to the posterior cerebral arteries that curve posteriorly around the midbrain. Anteriorly and anterolaterally, the internal carotid arteries feed into the circle of Willis via the anterior and middle cerebral arteries, with the posterior communicating arteries linking carotid to vertebrobasilar circulation. Dural venous channels are suggested in blue, framing arterial anatomy against the inner table of the skull. Orientation at the foramen magnum makes this view clinically specific. Vertebral artery anatomy at the craniovertebral junction underpins posterior circulation stroke patterns, vertebral artery dissection after cervical rotation or minor trauma, and the safe corridor for far-lateral and retrosigmoid approaches when working near the lower clivus, jugular tubercle, and cerebellomedullary cistern. A small asymmetry in vertebral caliber or a hypoplastic PICA, common variants, changes collateral flow through the circle of Willis and becomes relevant when planning endovascular access to basilar or posterior cerebral targets. Posterior circulation is unforgiving. Use this plate for neuroanatomy teaching on the vertebrobasilar system, for neurosurgical atlases discussing craniocervical approaches, or for radiology education when correlating CTA/MRA findings with the expected course of the vertebral arteries after they enter the skull. It also fits stroke education materials that distinguish anterior versus posterior circulation territories. Anatomical accuracy verified by SciePro's Medical Advisory Board.