Advertisement

Neuroradiology

, Volume 54, Issue 1, pp 19–23 | Cite as

Vertebral artery variations at the C1–2 level diagnosed by magnetic resonance angiography

  • Akira UchinoEmail author
  • Naoko Saito
  • Takeyuki Watadani
  • Yoshitaka Okada
  • Eito Kozawa
  • Naoko Nishi
  • Waka Mizukoshi
  • Kaiji Inoue
  • Reiko Nakajima
  • Masahiro Takahashi
Diagnostic Neuroradiology

Abstract

Introduction

The craniovertebral junction is clinically important. The vertebral artery (VA) in its several variations runs within this area. We report the prevalence of these VA variations on magnetic resonance angiography (MRA).

Methods

We retrospectively reviewed MRA images, obtained using two 1.5-T imagers, of 2,739 patients, and paid special attention to the course and branching of the VA at the level of the C1–2 vertebral bodies.

Results

There were three types of VA variation at the C1–2 level: (1) persistent first intersegmental artery (FIA), (2) VA fenestration, and (3) posterior inferior cerebellar artery (PICA) originating from the C1/2 level. The overall prevalence of these three variations was 5.0%. There was no laterality in frequency, but we found female predominance (P < 0.05). We most frequently observed the persistent FIA (3.2%), which was sometimes bilateral. We found VA fenestration (0.9%) and PICA of C1/2 origin (1.1%) with almost equal frequency. Two PICAs of C1/2 origin had no normal VA branch.

Conclusions

We frequently observed VA variations at the C1–2 level and with female predominance. The persistent FIA was most prevalent and sometimes seen bilaterally. Preoperative identification of these variations in VA is necessary to avoid complications during surgery at the craniovertebral junction.

Keywords

Arterial variation Craniovertebral junction Magnetic resonance angiography Posterior inferior cerebellar artery Vertebral artery 

Notes

Acknowledgments

We are grateful to Rosalyn Uhrig, M.A., for editorial assistance in the preparation of this manuscript.

Conflict of interest

We declare that we have no conflict of interest.

References

  1. 1.
    Tokuda K, Miyasaka K, Abe H et al (1985) Anomalous atlantoaxial portions of vertebral and posterior inferior cerebellar arteries. Neuroradiology 27:410–413PubMedCrossRefGoogle Scholar
  2. 2.
    Yamazaki M, Koda M, Aramomi MA et al (2005) Anomalous vertebral artery at the extraosseous and intraosseous regions of the craniovertebral junction: analysis by three-dimensional computed tomography angiography. Spine (Phila PA 1976) 30:2452–2457CrossRefGoogle Scholar
  3. 3.
    Yamazaki M, Okawa A, Hashimoto M et al (2008) Abnormal course of the vertebral artery at the craniovertebral junction in patients with Down syndrome visualized by three-dimensional CT angiography. Neuroradiology 50:485–490PubMedCrossRefGoogle Scholar
  4. 4.
    Padget DH (1948) The development of cranial arteries in the human embryo. Contrib Embryol 32:207–261Google Scholar
  5. 5.
    Sato K, Watanabe T, Yoshimoto T et al (1994) Magnetic resonance imaging of C2 segmental type of vertebral artery. Surg Neurol 41:45–51PubMedCrossRefGoogle Scholar
  6. 6.
    Takahashi M, Kawanami H, Watanabe N et al (1970) Fenestration of the extra-cranial vertebral artery. Radiology 96:359–360PubMedGoogle Scholar
  7. 7.
    Carella A, Lamberti P, Federico F et al (1978) Double fenestration of the extracranial vertebral artery. Neuroradiology 15:193–194PubMedCrossRefGoogle Scholar
  8. 8.
    Uchino A, Tanaka M, Kuromatsu C et al (1983) A case of bilateral extracranial fenestrations of the vertebral arteries. Rinsho Hoshasen 28:147–149, Article in JapanesePubMedGoogle Scholar
  9. 9.
    Fine AD, Cardoso A, Rhoton AL Jr (1999) Microsurgical anatomy of the extracranial–extradural origin of the posterior inferior cerebellar artery. J Neurosurg 91:645–652PubMedCrossRefGoogle Scholar
  10. 10.
    Tabatabai SA, Zadeh MZ, Meybodi AT et al (2007) Extracranial aneurysm of the posterior inferior cerebellar artery with an aberrant origination: case report. Neurosurgery 61:E1097–E1098PubMedCrossRefGoogle Scholar
  11. 11.
    Bhat DI, Somanna S, Kovoor J et al (2009) Aneurysms from extracranial, extradurally originating posterior inferior cerebellar arteries: a rare case report. Surg Neurol 72:406–408PubMedCrossRefGoogle Scholar
  12. 12.
    Takahashi T, Tominaga T, Hassan T et al (2003) Cervical cord compression with myelopathy caused by bilateral persistence of the first intersegmental arteries: case report. Neurosurgery 53:234–237PubMedCrossRefGoogle Scholar
  13. 13.
    Brinjikji W, Cloft H, Kallmes DF (2009) Anatomy of the posterior inferior cerebellar artery: relevance for C1–C2 puncture procedures. Clin Anat 22:319–323PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Akira Uchino
    • 1
    Email author
  • Naoko Saito
    • 1
  • Takeyuki Watadani
    • 1
  • Yoshitaka Okada
    • 1
  • Eito Kozawa
    • 1
  • Naoko Nishi
    • 1
  • Waka Mizukoshi
    • 1
  • Kaiji Inoue
    • 1
  • Reiko Nakajima
    • 1
  • Masahiro Takahashi
    • 1
  1. 1.Department of Diagnostic RadiologySaitama Medical University International Medical CenterHidakaJapan

Personalised recommendations