Which artery is the largest branch off the vertebral artery?

• A. Basilar Artery
• B. Posterior Inferior Cerebellar Artery
• C. Anterior Spinal Artery
• D. Superior Cerebellar Artery

Answer: (B)

The main idea here is how the vertebral arteries branch as they ascend. The posterior inferior cerebellar artery is typically the largest branch of the vertebral artery, arising as the vertebral artery nears the medulla and wrapping around the inferior aspect of the cerebellum to supply its posteroinferior region and parts of the lateral medulla. The basilar artery is not a branch; it is formed by the fusion of the two vertebral arteries. The anterior spinal artery is a midline vessel formed by contributions from each vertebral artery but is not the largest branch. The superior cerebellar artery comes off the basilar artery, not directly from the vertebral. So the best answer is the posterior inferior cerebellar artery.