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A posterior inferior cerebellar artery of C2 transverse foramen level origin that entered the spinal canal via the C1/2 intervertebral space demonstrated by computed tomography angiography

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Abstract

Purpose

To describe a case of a posterior inferior cerebellar artery (PICA) of C2 transverse foramen level vertebral artery (VA) origin that entered the spinal canal via the C1/2 intervertebral space.

Case report

A 48-year-old man with posterior neck pain underwent computed tomography (CT) angiography and selective left vertebral angiography. Arterial dissection was found at the distal V2 segment of the left VA on subtracted CT angiography. The left PICA arising from the VA at the level of C2 transverse foramen was identified on CT angiography with bone imaging. This PICA of extracranial origin entered the spinal canal via the C1/2 intervertebral space, just like a PICA of C1/2 level origin.

Discussion

The origins of PICAs show several variations. PICAs originating at the extracranial C1/2 level VA are relatively rare, with a reported prevalence of approximately 1%. Our patient had a left PICA arising from the VA at the level of the C2 transverse foramen. No similar cases have been reported in the relevant English-language literature. We speculated that the proximal short segment of the PICA arising from the C1/2 level VA regressed incidentally and that the distal segment of the PICA was supplied by the muscular branch of the VA arising from the level of the C2 transverse foramen.

Conclusion

We reported the first case of PICA arising from the C2 transverse foramen level VA. CT angiography with bone imaging is useful for identifying a PICA arising from the extracranial VA.

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(Modified from Reference #12)

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Funding

The authors did not receive support from any organization for the submitted work.

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Authors and Affiliations

  1. Department of Radiology, Saitama Sekishinkai Hospital, 2-37-20 Irumagawa, Sayama, Saitama, 350-1305, Japan

    Akira Uchino

  2. Department of Neuroendovascular Therapy, Saitama Sekishinkai Hospital, 2-37-20 Irumagawa, Sayama, Saitama, 350-1305, Japan

    Yoshiaki Kakehi

Authors
  1. Akira Uchino
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  2. Yoshiaki Kakehi
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Contributions

AU carried out the study design and drafted the manuscript. AU and YK reviewed the manuscript critically, and have read and approved the final manuscript.

Corresponding author

Correspondence to Akira Uchino.

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Uchino, A., Kakehi, Y. A posterior inferior cerebellar artery of C2 transverse foramen level origin that entered the spinal canal via the C1/2 intervertebral space demonstrated by computed tomography angiography. Surg Radiol Anat 45, 833–837 (2023). https://doi.org/10.1007/s00276-023-03165-0

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