Child's Nervous System

, Volume 35, Issue 4, pp 683–687 | Cite as

Vertebral artery segment at the suboccipital dural penetration site: an anatomical study using magnetic resonance imaging

  • Satoshi TsutsumiEmail author
  • Hideo Ono
  • Hisato Ishii
  • Yukimasa Yasumoto
Original Article



The morphology of the vertebral artery (VA) segment at the suboccipital dural penetration site has little been explored with magnetic resonance imaging (MRI). Therefore, the aim of this study was to examine the structure using MRI.


In total, 94 patients underwent thin-sliced, contrast MRI in the axial, coronal, and sagittal planes involving the atlas, axis, occipital bone, and V3 and V4 segments of the VA.


The VA segment at the suboccipital dural penetration site was well-delineated in 93% on the axial images and in 95% on the coronal images. The axial images showed that 82% of the VA penetration sites were located in the middle third of the dural sac. Meanwhile, the coronal images revealed that the heights of both VA penetration sites were located at the same level in 87%. The axial VA penetration angle, which is formed by the VA and tangential line of the dural sac, was 66 ± 11.9° on the right side and 61 ± 14.1° on the left side. The coronal VA penetration angle, which is formed by the tangential line of the VA and dural sac, was 111 ± 24.6° on the right side and 112 ± 19.9° on the left side.


The morphology of the VA segment is considerably variable at the suboccipital dural penetration site, while most penetration sites are located in the middle third of the dural sac on axial MRI. These should be assumed during surgeries around the suboccipital VA penetration site.


Vertebral artery Suboccipital Dural penetration MRI 


Author contributions

ST conceptualized the project of the study.

HI and YY collected the imaging data.

HO and HI analyzed the imaging data.

ST wrote the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Satoshi Tsutsumi
    • 1
    Email author
  • Hideo Ono
    • 2
  • Hisato Ishii
    • 1
  • Yukimasa Yasumoto
    • 1
  1. 1.Department of Neurological SurgeryJuntendo University Urayasu HospitalUrayasuJapan
  2. 2.Division of Radiological TechnologyMedical Satellite Yaesu ClinicTokyoJapan

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