Skip to main content
SpringerLink
Log in

Anatomical variations

  • Chapter
Pathology and surgery around the vertebral artery

Abstract

Numerous anatomical variations of the vertebral artery (VA) have been reported in the literature. Most of the time, these variations are not clinically relevant. However, having their knowledge is especially important to look for on preoperative workup. This step is the mandatory prerequisite for working in safe conditions with the lowest risk of VA injury due to an aberrant course.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 329.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Lasjaunias P, Berenstein A, Ter Brugge KG (2001) Surgical neuroangiography. Springer-Verlag, Berlin.

    Google Scholar 

  2. Bruneau M, Cornelius JF, George B (2006) Anterolateral approach to the V1 segment of the vertebral artery. Neurosurgery 58:ONS–215–9 [discussion ONS-9].

    PubMed  Google Scholar 

  3. Bruneau M, Cornelius JF, George B (2006) Antero-lateral approach to the V3 segment of the vertebral artery. Neurosurgery 58:ONS29–35 [discussion ONS29-35].

    PubMed  Google Scholar 

  4. George B, Cornelius JF (2001) Vertebral artery: surgical anatomy. In: Spetzler RF (ed) Operative techniques in neurosurgery. W.B. Saunders, Philadelphia, p. 168–81.

    Google Scholar 

  5. Peltier J, Toussaint P, Deramond H, et al. (2003) The dural crossing of the vertebral artery. Surg Radiol Anat 25:305–10.

    Article  PubMed  CAS  Google Scholar 

  6. Krayenbühl H, Yasargyl MG (1982) Cerebral angiography. In: Huber P (ed) Georg Thieme Verlag, Stuttgart/New York.

    Google Scholar 

  7. Park JH, Kim JM, Roh JK (2007) Hypoplastic vertebral artery: frequency and associations with ischaemic stroke territory. J Neurol Neurosurg Psychiatry 78:954–8.

    Article  PubMed  Google Scholar 

  8. Jeng JS, Yip PK (2004) Evaluation of vertebral artery hypoplasia and asymmetry by color-coded duplex ultrasonography. Ultrasound Med Biol 30:605–9.

    Article  PubMed  Google Scholar 

  9. Touboul PJ, Bousser MG, LaPlane D, et al. (1986) Duplex scanning of normal vertebral arteries. Stroke 17:921–3.

    Article  PubMed  CAS  Google Scholar 

  10. Matula C, Trattnig S, Tschabitscher M, et al. (1997) The course of the prevertebral segment of the vertebral artery: anatomy and clinical significance. Surg Neurol 48:125–31.

    Article  PubMed  CAS  Google Scholar 

  11. Chuang YM, Huang YC, Hu HH, et al. (2006) Toward a further elucidation: role of vertebral artery hypoplasia in acute ischemic stroke. Eur Neurol 55:193–7.

    Article  PubMed  Google Scholar 

  12. Lovrencic-Huzjan A, Demarin V, Bosnar M, et al. (1999) Color Doppler flow imaging (CDFI) of the vertebral arteries — the normal appearance, normal values and the proposal for the standards. Coll Antropol 23:175–81.

    PubMed  CAS  Google Scholar 

  13. Francke JP, Di Marino V, Pannier M, et al. (1980) Les artères vertébrales, segments atlanto-axo V3 et intracrânien V4. Anat Clin 2:229–42 [in French].

    Article  Google Scholar 

  14. Cagnie B, Barbaix E, Vinck E, et al. (2005) A vertebral artery without atlantic and intradural sections: a case report and a review of the literature. Ann Anat 187:271–5.

    Article  PubMed  Google Scholar 

  15. Cagnie B, Barbaix E, Vinck E, et al. (2005) Extrinsic risk factors for compromised blood flow in the vertebral artery: anatomical observations of the transverse foramina from C3 to C7. Surg Radiol Anat 27:312–6.

    Article  PubMed  Google Scholar 

  16. Burger IM, Siclari F, Gregg L, et al. (2007) Bilateral segmental agenesis of the vertebrobasilar junction: developmental and angiographic anatomy. AJNR Am J Neuroradiol 28:2017–22.

    Article  PubMed  CAS  Google Scholar 

  17. Min JH, Lee YS (2007) Transcranial Doppler ultrasonographic evaluation of vertebral artery hypoplasia and aplasia. J Neurol Sci 260:183–7.

    Article  PubMed  Google Scholar 

  18. Hachem K, Abi Khalil S, Slaba S, et al. (2008) Non invasive imaging of bilateral vertebral arteries agenesis. J Mal Vasc 33:26–9 [in French].

    Article  PubMed  CAS  Google Scholar 

  19. Springer TD, Fishbone G, Shapiro R (1974) Persistent hypoglossal artery associated with superior cerebellar artery aneurysm. Case report. J Neurosurg 40:297–9.

    PubMed  CAS  Google Scholar 

  20. Kodama N, Ohara H, Suzuki J (1976) Persistent hypoglossal artery associated with aneurysms. Report of two cases. J Neurosurg 45:449–51.

    Article  PubMed  CAS  Google Scholar 

  21. Yamamoto S, Sunada I, Matsuoka Y, et al. (1991) Persistent primitive hypoglossal artery aneurysms — report of two cases. Neurol Med Chir (Tokyo) 31:199–202.

    Article  CAS  Google Scholar 

  22. Kwak R, Emori T, Yamamoto N, et al. (1983) Moyamoya disease associated with persistent primitive trigeminal artery — report of two cases. No To Shinkei 35:237–42 [in Japanese].

    PubMed  CAS  Google Scholar 

  23. Katayama W, Enomoto T, Yanaka K, et al. (2001) Moyamoya disease associated with persistent primitive hypoglossal artery: report of a case. Pediatr Neurosurg 35:262–5.

    Article  PubMed  CAS  Google Scholar 

  24. Nishida C, Ashikaga R, Araki Y, et al. (2000) Persistent hypoglossal artery associated with arteriovenous malformation: a case report. Eur J Radiol 33:59–62.

    Article  PubMed  CAS  Google Scholar 

  25. Garza-Mercado R, Cavazos E, Urrutia G (1990) Persistent hypoglossal artery in combination with multifocal arteriovenous malformations of the brain: case report. Neurosurgery 26:871–6.

    Article  PubMed  CAS  Google Scholar 

  26. Wagner AL (2001) Isolated stenosis of a persistent hypoglossal artery visualized at 3D CT angiography. AJNR Am J Neuroradiol 22:1613–4.

    PubMed  CAS  Google Scholar 

  27. Hatayama T, Yamane K, Shima T, et al. (1999) Persistent primitive hypoglossal artery associated with cerebral aneurysm and cervical internal carotid artery stenosis — case report. Neurol Med Chir (Tokyo) 39:372–5.

    Article  CAS  Google Scholar 

  28. Gilmartin D (1963) Hypoglossal artery associated with internal carotid stenosis. Br J Radiol 36:849–51.

    Article  PubMed  CAS  Google Scholar 

  29. Fantini GA, Reilly LM, Stoney RJ (1994) Persistent hypoglossal artery: diagnostic and therapeutic considerations concerning carotid thromboendarterectomy. J Vasc Surg 20:995–9.

    Article  PubMed  CAS  Google Scholar 

  30. Thayer WP, Gaughen JR, Harthun NL (2005) Surgical revascularization in the presence of a preserved primitive carotid-basilar communication. J Vasc Surg 41:1066–9.

    Article  PubMed  Google Scholar 

  31. Pasco A, Papon X, Bracard S, et al. (2004) Persistent carotid-vertebrobasilar anastomoses: how and why differentiating them? J Neuroradiol 31:391–6.

    Article  PubMed  CAS  Google Scholar 

  32. Woodcock RJ, Cloft HJ, Dion JE (2001) Bilateral type 1 proatlantal arteries with absence of vertebral arteries. AJNR Am J Neuroradiol 22:418–20.

    PubMed  CAS  Google Scholar 

  33. Lui CC, Liu YH, Wai YY, et al. (1987) Persistence of both proatlantal arteries with absence of vertebral arteries. Neuroradiology 29:304–5.

    Article  PubMed  CAS  Google Scholar 

  34. Tanaka Y, Hara H, Momose G, et al. (1983) Proatlantal inter-segmental artery and trigeminal artery associated with an aneurysm. Case report. J Neurosurg 59:520–3.

    Article  PubMed  CAS  Google Scholar 

  35. Lode I (2000) Persistence of both proatlantal arteries with occlusion of the internal carotid arteries. A case report. Acta Radiol 41:410–1.

    PubMed  CAS  Google Scholar 

  36. Al-Memar A, Thrush D (1998) Unilateral hypoglossal nerve palsy due to aneurysm of the stump of persistent hypoglossal artery. J Neurol Neurosurg Psychiatry 64:405.

    Article  PubMed  CAS  Google Scholar 

  37. Kempe LG, Smith DR (1969) Trigeminal neuralgia, facial spasm, intermedius and glossopharyngeal neuralgia with persistent carotid basilar anastomosis. J Neurosurg 31:445–51.

    Article  PubMed  CAS  Google Scholar 

  38. Kolbinger R, Heindel W, Pawlik G, et al. (1993) Right proatlantal artery type I, right internal carotid occlusion, and left internal carotid stenosis: case report and review of the literature. J Neurol Sci 117:232–9.

    Article  PubMed  CAS  Google Scholar 

  39. Bahsi YZ, Uysal H, Peker S, et al. (1993) Persistent primitive proatlantal intersegmental artery (proatlantal artery I) results in ‘top of the basilar’ syndrome. Stroke 24:2114–7.

    Article  PubMed  CAS  Google Scholar 

  40. Salas E, Ziyal IM, Sekhar LN, et al. (1998) Persistent trigeminal artery: an anatomic study. Neurosurgery 43:557–61 [discussion 61-2].

    Article  PubMed  CAS  Google Scholar 

  41. Suttner N, Mura J, Tedeschi H, et al. (2000) Persistent trigeminal artery: a unique anatomic specimen — analysis and therapeutic implications. Neurosurgery 47:428–33 [discussion 33-4].

    Article  PubMed  CAS  Google Scholar 

  42. Agnoli AL (1982) Vascular anomalies and subarachnoid haemorrhage associated with persisting embryonic vessels. Acta Neurochir (Wien) 60:183–99.

    Article  CAS  Google Scholar 

  43. Boyko OB, Curnes JT, Blatter DD, et al. (1996) MRI of basilar artery hypoplasia associated with persistent primitive trigeminal artery. Neuroradiology 38:11–4.

    Article  PubMed  CAS  Google Scholar 

  44. Ekinci G, Baltacioglu F, Kilic T, et al. (2001) A rare cause of hyperprolactinemia: persistent trigeminal artery with stalk-section effect. Eur Radiol 11:648–50.

    Article  PubMed  CAS  Google Scholar 

  45. McCormick WF (1969) Vascular disorders of nervous tissue: anomalies, malformations, and aneurysms. In: Bourne GH (ed) The structure and function of nervous tissue. Academic Press, New York, p. 537–95.

    Google Scholar 

  46. Croft HJ (2004) Persistent otic artery. AJNR Am J Neuroradiol 25:162.

    PubMed  Google Scholar 

  47. Patel AB, Gandhi CD, Bederson JB (2003) Angiographic documentation of a persistent otic artery. AJNR Am J Neuroradiol 24:124–6.

    PubMed  Google Scholar 

  48. Hassen-Khoja R, Declemy S, Batt M, et al. (1994) Anomalies congénitales des artères à destinée cérébrale. In: Kieffer E, Godeau P (eds) Maladies artérielles non athéroscléreuses de l’adulte. AERCV, Paris, p. 3–19 [in French].

    Google Scholar 

  49. Padget DH (1954) Designation of the embryonic inter-segmental arteries in reference to the vertebral artery and subclavian stem. Anat Rec 119:349–56.

    Article  PubMed  CAS  Google Scholar 

  50. Samra K, Scoville WB, Yaghmai M (1969) Anastomosis of carotid and basilar arteries. Persistent primitive trigeminal artery and hypoglossal artery: report of two cases. J Neurosurg 30:622–5.

    Article  PubMed  CAS  Google Scholar 

  51. Resche F, Resche-Perrin I, Robert R, et al. (1980) The hypoglossal artery. A new case report — review of the literature. J Neuroradiol 7:27–43 [in French].

    PubMed  CAS  Google Scholar 

  52. Welten RJ, Eikelboom BC, Ackerstaff RG, et al. (1988) A persistent hypoglossal artery arising from the external carotid artery. Eur J Vasc Surg 2:269–72.

    Article  PubMed  CAS  Google Scholar 

  53. Meguro T, Terada K, Hirotsune N, et al. (2007) Unusual variant of persistent primitive hypoglossal artery. Br J Radiol 80:e314–6.

    Article  PubMed  CAS  Google Scholar 

  54. Lasjaunias P, Berenstein A, Ter Brugge KG (2001) The pharyngo-occipital system. In: Berenstein A, Lasjaunias P, Ter Brugge KG (eds) Surgical neuro-angiography. Springer-Verlag, Berlin, p. 165–224.

    Google Scholar 

  55. Purkayastha S, Gupta AK, Varma R, et al. (2005) Proatlantal intersegmental arteries of external carotid artery origin associated with Galen’s vein malformation. AJNR Am J Neuroradiol 26:2378–83.

    PubMed  Google Scholar 

  56. Hutchinson NA, Miller JD (1970) Persistent proatlantal artery. J Neurol Neurosurg Psychiatry 33:524–7.

    Article  PubMed  CAS  Google Scholar 

  57. Gumus T, Onal B, Ilgit ET (2004) Bilateral persistence of type 1 proatlantal arteries: report of a case and review of the literature. AJNR Am J Neuroradiol 25:1622–4.

    PubMed  Google Scholar 

  58. Kurose K, Kishi H, Nishijima Y (1990) Type 2 proatlantal artery associated with a ruptured aneurysm — case report. Neurol Med Chir (Tokyo) 30:191–3.

    Article  CAS  Google Scholar 

  59. Tsai FY, Mahon J, Woodruff JV, et al. (1975) Congenital absence of bilateral vertebral arteries with occipital-basilar anastomosis. Am J Roentgenol Radium Ther Nucl Med 124:281–6.

    Article  PubMed  CAS  Google Scholar 

  60. Satti SR, Cerniglia CA, Koenigsberg RA (2007) Cervical vertebral artery variations: an anatomic study. AJNR Am J Neuroradiol 28:976–80.

    PubMed  CAS  Google Scholar 

  61. Ionete C, Omojola MF (2006) MR angiographic demonstration of bilateral duplication of the extracranial vertebral artery: unusual course and review of the literature. AJNR Am J Neuroradiol 27:1304–6.

    PubMed  CAS  Google Scholar 

  62. Kowada M, Kikuchi K (1979) Symmetrical extracranial fenestrations of the vertebral artery. Two cases revealed by angiography. Radiology 131:408.

    PubMed  CAS  Google Scholar 

  63. Kowada M, Takahashi M, Tamakawa Y, et al. (1975) Fenestration of the basilar and vertebral arteries. In: Kitamura H, Newton TH (eds) Recent advances in diagnostic neuroradiology. Igaku-Shoin, Tokyo, p. 144–9.

    Google Scholar 

  64. Kowada M, Takahashi M, Gito Y, et al. (1973) Fenestration of the vertebral artery: report of 2 cases demonstrated by angiography. Neuroradiology 6:110–2.

    Article  PubMed  CAS  Google Scholar 

  65. Kowada M, Yamaguchi K, Takahashi H (1972) Fenestration of the vertebral artery with a review of 23 cases in Japan. Radiology 103:343–6.

    PubMed  CAS  Google Scholar 

  66. Kowada M, Yamaguchi K, Takahashi H, et al. (1970) A case of two fenestrations of the vertebral artery. Brain Nerve 22:469–72.

    PubMed  CAS  Google Scholar 

  67. Carella A, Lamberti P, Federico F, et al. (1978) Double fenestration of the extracranial vertebral artery. Neuroradiology 15:193–4.

    Article  PubMed  CAS  Google Scholar 

  68. Sim E, Vaccaro AR, Berzlanovich A, et al. (2001) Fenestration of the extracranial vertebral artery: review of the literature. Spine 26:E139–42.

    Article  PubMed  CAS  Google Scholar 

  69. Lasjaunias P (1983) Craniofacial and upper cervical arteries: collateral circulations and angiographie protocols. Williams and Wilkins, Baltimore/London.

    Google Scholar 

  70. Takasato Y, Hayashi H, Kobayashi T, et al. (1992) Duplicated origin of right vertebral artery with rudimentary and accessory left vertebral arteries. Neuroradiology 34:287–9.

    Article  PubMed  CAS  Google Scholar 

  71. Suzuki S, Kuwabara Y, Hatano R, et al. (1978) Duplicate origin of left vertebral artery. Neuroradiology 15:27–9.

    Article  PubMed  Google Scholar 

  72. Rieger P, Huber G (1983) Fenestration and duplicate origin of the left vertebral artery in angiography. Report of three cases. Neuroradiology 25:45–50.

    Article  PubMed  CAS  Google Scholar 

  73. Hashimoto H, Ohnishi H, Yuasa T, et al. (1987) Duplicate origin of the vertebral artery: report of two cases. Neuroradiology 29:301–3.

    Article  PubMed  CAS  Google Scholar 

  74. Eisenberg RA, Vines FS, Taylor SB (1986) Bifid origin of the left vertebral artery. Radiology 159:429–30.

    PubMed  CAS  Google Scholar 

  75. Takahashi M, Kawanami H, Watanabe N, et al. (1970) Fenestration of the extracranial vertebral artery. Radiology 96:359–60.

    PubMed  CAS  Google Scholar 

  76. Lasjaunias P, Braun JP, Hasso AN, et al. (1980) True and false fenestration of the vertebral artery. J Neuroradiol 7:157–66.

    PubMed  CAS  Google Scholar 

  77. Tran-Dinh HD, Soo YS, Jayasinghe LS (1991) Duplication of the vertebro-basilar system. Australas Radiol 35:220–4.

    Article  PubMed  CAS  Google Scholar 

  78. Osborn AG (1999) The vertebrobasilar system. Diagnostic cerebral angiography. Lippincott Williams & Wilkins, Philadelphia, p. 173–94.

    Google Scholar 

  79. Tsai IC, Tzeng WS, Lee T, et al. (2007) Vertebral and carotid artery anomalies in patients with aberrant right subclavian arteries. Pediatr Radiol 37:1007–12.

    Article  PubMed  Google Scholar 

  80. Lemke AJ, Benndorf G, Liebig T, et al. (1999) Anomalous origin of the right vertebral artery: review of the literature and case report of right vertebral artery origin distal to the left subclavian artery. AJNR Am J Neuroradiol 20:1318–21.

    PubMed  CAS  Google Scholar 

  81. Strub WM, Leach JL, Tomsick TA (2006) Left vertebral artery origin from the thyrocervical trunk: a unique vascular variant. AJNR Am J Neuroradiol 27:1155–6.

    PubMed  CAS  Google Scholar 

  82. Goray VB, Joshi AR, Garg A, et al. (2005) Aortic arch variation: a unique case with anomalous origin of both vertebral arteries as additional branches of the aortic arch distal to left subclavian artery. AJNR Am J Neuroradiol 26:93–5.

    PubMed  Google Scholar 

  83. Akdeniz B, Yilmaz E, Pekel N, et al. (2007) Anomalous origin of the right vertebral artery from the ascending aorta in the presence of an aberrant right subclavian artery. Int J Cardiovasc Imaging 23:39–42.

    Article  PubMed  Google Scholar 

  84. Wasserman BA, Mikulis DJ, Manzione JV (1992) Origin of the right vertebral artery from the left side of the aortic arch proximal to the origin of the left subclavian artery. AJNR Am J Neuroradiol 13:355–8.

    PubMed  CAS  Google Scholar 

  85. Stoesslein F, Porstmann W, Schueler F, et al. (1982) Aberrant vertebral artery originating from the descending aorta: a new congenital steal syndrome in coarctation. Eur J Radiol 2:157–9.

    PubMed  CAS  Google Scholar 

  86. Sakamoto H (1980) A case of the right vertebral artery as the last branch of the aortic arch. Kaibogaku Zasshi 55:503–8 [author’s translation, in Japanese].

    PubMed  CAS  Google Scholar 

  87. Schwarzacher SW, Krammer EB (1989) Complex anomalies of the human aortic arch system: unique case with both vertebral arteries as additional branches of the aortic arch. Anat Rec 225:246–50.

    Article  PubMed  CAS  Google Scholar 

  88. Takagi T, Yamashita K (1992) Right vertebral artery as the last branch of the aortic arch and a coronary sinus opening into the left atrium as found in a cadaver. Kaibogaku Zasshi 67:49–52.

    PubMed  CAS  Google Scholar 

  89. Al-Okaili R, Schwartz ED (2007) Bilateral aortic origins of the vertebral arteries with right vertebral artery arising distal to left subclavian artery: case report. Surg Neurol 67:174–6 [discussion 6].

    Article  PubMed  Google Scholar 

  90. Ugurlucan M, Sayin OA, Surmen B, et al. (2006) Common carotid trunk and right vertebral artery originating from the right common carotid artery in a patient with carotid stenosis. J Card Surg 21:423–4.

    Article  PubMed  Google Scholar 

  91. Layton KF, Miller GM, Kalina P (2006) Aberrant origin of the right vertebral artery from the right common carotid artery: depiction of a rare vascular anomaly on magnetic resonance angiography. J Vasc Interv Radiol 17:1065–7.

    Article  PubMed  Google Scholar 

  92. Yanik B, Conkbayir I, Keyik B, et al. (2004) A rare anomalous origin of right vertebral artery: findings on Doppler sonography. J Clin Ultrasound 32:211–4.

    Article  PubMed  Google Scholar 

  93. Huber G, Piepgras U (1976) Origin of the left vertebral artery from the left external carotid artery. Rofo 125:63–6 [author’s translation].

    Article  PubMed  CAS  Google Scholar 

  94. Flynn RE (1968) External carotid origin of the dominant vertebral artery. Case report. J Neurosurg 29:300–1.

    Article  PubMed  CAS  Google Scholar 

  95. Nathan H, Seidel MR (1983) The association of a retro-esophageal right subclavian artery, a right-sided terminating thoracic duct, and a left vertebral artery of aortic origin: anatomical and clinical considerations. Acta Anat (Basel) 117:362–73.

    Article  CAS  Google Scholar 

  96. Fazan VP, Caetano AG, Filho OA (2004) Anomalous origin and cervical course of the vertebral artery in the presence of a retroesophageal right subclavian artery. Clin Anat 17:354–7.

    Article  PubMed  Google Scholar 

  97. Gluncic V, Ivkic G, Marin D, et al. (1999) Anomalous origin of both vertebral arteries. Clin Anat 12:281–4.

    Article  PubMed  CAS  Google Scholar 

  98. Komiyama M, Nakajima H, Yamanaka K, et al. (1999) Dual origin of the vertebral artery — case report. Neurol Med Chir (Tokyo) 39:932–7.

    Article  CAS  Google Scholar 

  99. Thomas AJ, Germanwala AV, Vora N, et al. (2008) Dual origin extracranial vertebral artery: case report and embryology. J Neuroimaging 18:173–6.

    Article  PubMed  Google Scholar 

  100. Shhadeh A, Sair HI, Kanamalla US (2007) Bifid direct aortic arch origin of left vertebral artery: a unique vascular variant. J Vasc Interv Radiol 18:1051–3.

    Article  PubMed  Google Scholar 

  101. Nogueira TE, Chambers AA, Brueggemeyer MT, et al. (1997) Dual origin of the vertebral artery mimicking dissection. AJNR Am J Neuroradiol 18:382–4.

    PubMed  CAS  Google Scholar 

  102. Kiss J (1968) Bifid origin of the right vertebral artery: a case report. Radiology 91:931.

    PubMed  CAS  Google Scholar 

  103. Brugieres P, Djindjian M, Revel MP, et al. (1990) Anterior cervical spinal artery originating from a right vertebral artery with a bifid origin. Neuroradiology 32:506–7.

    Article  PubMed  CAS  Google Scholar 

  104. Mahmutyazicioglu K, Sarac K, Boluk A, et al. (1998) Duplicate origin of left vertebral artery with thrombosis at the origin: color Doppler sonography and CT angiography findings. J Clin Ultrasound 26:323–5.

    Article  PubMed  CAS  Google Scholar 

  105. Nishijima M, Harada J, Akai T, et al. (1989) Operative correction of a kinked duplicate origin of the vertebral artery in a patient with dizziness. Case report. Surg Neurol 32:356–9.

    Article  PubMed  CAS  Google Scholar 

  106. Bruneau M, Cornelius JF, Marneffe V, et al. (2006) Anatomical variations of the V2 segment of the vertebral artery. Neurosurgery 59:ONS20–4 [discussion ONS-4].

    Article  PubMed  Google Scholar 

  107. Brink B (1984) Approach to the second segment of the vertebral arteries. In: Berguer R, Bauer RB (eds) Vertebrobasilar arterial occlusive disease: medical and surgical management. Raven Press, New York, p. 257–64.

    Google Scholar 

  108. Anson JA, Spetzler RF (1995) Surgery for vertebrobasilar insufficiency. In: Carter LP, Spetzler RF, Hamilton MG (eds) Neurovascular surgery. McGraw-Hill, New York, p. 383–403.

    Google Scholar 

  109. Daseler EH, Anson BJ (1959) Surgical anatomy of the subclavian artery and its branches. Surg Gynecol Obstet 108:149–74.

    PubMed  CAS  Google Scholar 

  110. George B (2002) Extracranial vertebral artery anatomy and surgery. In: Krayenbühl H (ed) Advances and technical standards in neurosurgery. Springer-Verlag, New York, p. 179–216.

    Chapter  Google Scholar 

  111. Zimmerman HB, Farrell WJ (1970) Cervical vertebral erosion caused by vertebral artery tortuosity. Am J Roentgenol Radium Ther Nucl Med 108:767–70.

    Article  PubMed  CAS  Google Scholar 

  112. Lindsey RW, Piepmeier J, Burkus JK (1985) Tortuosity of the vertebral artery: an adventitious finding after cervical trauma. A case report. J Bone Joint Surg Am 67:806–8.

    PubMed  CAS  Google Scholar 

  113. Smith MD, Emery SE, Dudley A, et al. (1993) Vertebral artery injury during anterior decompression of the cervical spine. A retrospective review of ten patients. J Bone Joint Surg Br 75:410–5.

    PubMed  CAS  Google Scholar 

  114. Pfeifer BA, Freidberg SR, Jewell ER (1994) Repair of injured vertebral artery in anterior cervical procedures. Spine 19:1471–4.

    Article  PubMed  CAS  Google Scholar 

  115. Tumialan LM, Wippold FJ 2nd, Morgan RA (2004) Tortuous vertebral artery injury complicating anterior cervical spinal fusion in a symptomatic rheumatoid cervical spine. Spine 29: E343–8.

    Article  PubMed  Google Scholar 

  116. Paksoy Y, Levendoglu FD, Ogun CO, et al. (2003) Vertebral artery loop formation: a frequent cause of cervicobrachial pain. Spine 28:1183–8.

    PubMed  Google Scholar 

  117. Sakaida H, Okada M, Yamamoto A (2001) Vascular reconstruction of a vertebral artery loop causing cervical radiculopathy and vertebrobasilar insufficiency. Case report. J Neurosurg 94:145–9.

    PubMed  CAS  Google Scholar 

  118. Duthel R, Tudor C, Motuo-Fotso MJ, et al. (1994) Cervical root compression by a loop of the vertebral artery: case report. Neurosurgery 35:140–2.

    Article  PubMed  CAS  Google Scholar 

  119. Sharma RR, Parekh HC, Prabhu S, et al. (1993) Compression of the C-2 root by a rare anomalous ectatic vertebral artery. Case report. J Neurosurg 78:669–72.

    Article  PubMed  CAS  Google Scholar 

  120. Korinth MC, Mull M (2007) Vertebral artery loop causing cervical radiculopathy. Surg Neurol 67:172–3.

    Article  PubMed  Google Scholar 

  121. Detwiler PW, Porter RW, Harrington TR, et al. (1998) Vascular decompression of a vertebral artery loop producing cervical radiculopathy. Case report. J Neurosurg 89:485–8.

    Article  PubMed  CAS  Google Scholar 

  122. Lot G, George B (1997) Cervical neuromas with extradural components: surgical management in a series of 57 patients. Neurosurgery 41:813–20 [discussion 20-2].

    Article  PubMed  CAS  Google Scholar 

  123. Kawashima M, Tanriover N, Rhoton Jr AL, et al. (2003) The transverse process, intertransverse space, and vertebral artery in anterior approaches to the lower cervical spine. J Neurosurg 98:188–94.

    PubMed  Google Scholar 

  124. Neo M, Matsushita M, Iwashita Y, et al. (2003) Atlantoaxial transarticular screw fixation for a high-riding vertebral artery. Spine 28:666–70.

    PubMed  Google Scholar 

  125. Mandel IM, Kambach BJ, Petersilge CA, et al. (2000) Morphologic considerations of C2 isthmus dimensions for the placement of transarticular screws. Spine 25:1542–7.

    Article  PubMed  CAS  Google Scholar 

  126. Song GS, Theodore N, Dickman CA, et al. (1997) Unilateral posterior atlantoaxial transarticular screw fixation. J Neurosurg 87:851–5.

    Article  PubMed  CAS  Google Scholar 

  127. 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 30:2452–7.

    Article  PubMed  Google Scholar 

  128. Kazan S, Yildirim F, Sindel M, et al. (2000) Anatomical evaluation of the groove for the vertebral artery in the axis vertebrae for atlanto-axial transarticular screw fixation technique. Clin Anat 13:237–43.

    Article  PubMed  CAS  Google Scholar 

  129. Madawi AA, Casey AT, Solanki GA, et al. (1997) Radiological and anatomical evaluation of the atlantoaxial transarticular screw fixation technique. J Neurosurg 86:961–8.

    Article  PubMed  CAS  Google Scholar 

  130. Fine AD, Cardoso A, Rhoton Jr AL (1999) Microsurgical anatomy of the extracranial-extradural origin of the posterior inferior cerebellar artery. J Neurosurg 91:645–52.

    Article  PubMed  CAS  Google Scholar 

  131. Lasjaunias P, Vallee B, Person H, et al. (1985) The lateral spinal artery of the upper cervical spinal cord. Anatomy, normal variations, and angiographic aspects. J Neurosurg 63:235–41.

    Article  PubMed  CAS  Google Scholar 

  132. Salas E, Ziyal IM, Bank WO, et al. (1998) Extradural origin of the posteroinferior cerebellar artery: an anatomic study with histological and radiographic correlation. Neurosurgery 42:1326–31.

    Article  PubMed  CAS  Google Scholar 

  133. Tokuda K, Miyasaka K, Abe H, et al. (1985) Anomalous atlantoaxial portions of vertebral and posterior inferior cerebellar arteries. Neuroradiology 27:410–3.

    Article  PubMed  CAS  Google Scholar 

  134. Sato K, Watanabe T, Yoshimoto T, et al. (1994) Magnetic resonance imaging of C2 segmentai type of vertebral artery. Surg Neurol 41:45–51.

    Article  PubMed  CAS  Google Scholar 

  135. Jian FZ, Santoro A, Wang XW, et al. (2003) A vertebral artery tortuous course below the posterior arch of the atlas (without passing through the transverse foramen). Anatomical report and clinical significance. J Neurosurg Sci 47:183–7.

    PubMed  Google Scholar 

  136. Hotta S, Morita A, Seichi A, et al. (2005) Aberrant vertebral artery course in a case of Chiari malformation and occipitoatlantal assimilation. Case report. J Neurosurg Spine 3:246–8.

    Article  PubMed  Google Scholar 

  137. Yano K, Murase S, Kuroda T, et al. (1993) Cervical cord compression by the vertebral artery causing a severe cervical pain: case report. Surg Neurol 40:43–6.

    Article  PubMed  CAS  Google Scholar 

  138. Satoh S, Yamamoto N, Kitagawa Y, et al. (1993) Cervical cord compression by the anomalous vertebral artery presenting with neuralgic pain. Case report. J Neurosurg 79:283–5.

    Article  PubMed  CAS  Google Scholar 

  139. Morikawa K, Ohkawa N, Yamashita S (1993) Surgical decompression for the C-1 and C-2 sensory roots and upper cervical cord in a case with cervical myelopathy and occipital neuralgia due to bilateral fenestration of vertebral artery: a case report. No Shinkei Geka 21:1035–8.

    PubMed  CAS  Google Scholar 

  140. Kitagawa M, Nakagawa Y, Kitaoka K, et al. (1988) Accessory nerve paralysis due to compression of the fenestrated vertebral artery. No Shinkei Geka 16:1173–7.

    PubMed  CAS  Google Scholar 

  141. Hasegawa T, Kubota T, Ito H, et al. (1983) Symptomatic duplication of the vertebral artery. Surg Neurol 20:244–8.

    Article  PubMed  CAS  Google Scholar 

  142. Furumoto T, Nagase J, Takahashi K, et al. (1996) Cervical myelopathy caused by the anomalous vertebral artery. A case report. Spine 21:2280–3.

    Article  PubMed  CAS  Google Scholar 

  143. Ashley Jr WW, Chicoine MR (2005) Subarachnoid hemorrhage caused by posterior inferior cerebellar artery aneurysm with an anomalous course of the atlantoaxial segment of the vertebral artery. Case report and review of literature. J Neurosurg 103:356–60.

    Article  PubMed  Google Scholar 

  144. Gupta T (2008) Quantitative anatomy of vertebral artery groove on the posterior arch of atlas in relation to spinal surgical procedures. Surg Radiol Anat 30(3): 239–42.

    Article  PubMed  Google Scholar 

  145. Hasan M, Shulda S, Siddiqui MS, et al. (2001) Posterolateral tunnels and ponticuli in human atlas vertebrae. J Anat 199:339–43.

    Article  PubMed  CAS  Google Scholar 

  146. Paraskevas G, Papaziogas B, Tsonidis C, et al. (2005) Gross morphology of the bridges over the vertebral artery groove on the atlas. Surg Radiol Anat 27:129–36.

    Article  PubMed  Google Scholar 

  147. Mitchell J (1998) The incidence of the lateral bridge of the atlas vertebra. J Anat 193(Pt 2):283–5.

    Article  PubMed  Google Scholar 

  148. Bernard TJ, Mull BR, Handler MH, et al. (2007) An 18-year-old man with fenestrated vertebral arteries, recurrent stroke and successful angiographie coiling. J Neurol Sci 260:279–82.

    Article  PubMed  Google Scholar 

  149. Hayashi T, Hirose Y, Sagoh M, et al. (2000) Spontaneous occlusion of ruptured vertebral artery dissection at the extradural fenestration associated with extradural origin of the posterior inferior cerebellar artery — case report. Neurol Med Chir (Tokyo) 40:164–8.

    Article  CAS  Google Scholar 

  150. Sanders WP, Sorek PA, Mehta BA (1993) Fenestration of intracranial arteries with special attention to associated aneurysms and other anomalies. AJNR Am J Neuroradiol 14:675–80.

    PubMed  CAS  Google Scholar 

  151. de Andrade GC, de Oliveira JG, Dauar RF, et al. (2005) Dissecting aneurysm of the intracranial fenestrated vertebral artery submitted to endovascular treatment: case report. Arq Neuropsiquiatr 63:352–6.

    Article  PubMed  Google Scholar 

  152. Hyogo T, Nakagawara J, Nakamura J, et al. (1996) Multiple segmental agenesis of the cerebral arteries: case report. Neuroradiology 38:433–6.

    Article  PubMed  CAS  Google Scholar 

  153. Mahadevan J, Batista L, Alvarez H, et al. (2004) Bilateral segmental regression of the carotid and vertebral arteries with rete compensation in a Western patient. Neuroradiology 46:444–9.

    Article  PubMed  CAS  Google Scholar 

  154. Koenigsberg RA, McCormick D, Thomas C, et al. (2003) Vertigo secondary to isolated PICA insufficiency: successful treatment with balloon angioplasty. Surg Neurol 60:306–10.

    Article  PubMed  Google Scholar 

  155. Newton TH, Mani RL (1974) The vertebral artery. In: Newton TH, Potts DG (eds) Radiology of the skull and brain: angiography. Mosby, St. Louis, p. 1659–709.

    Google Scholar 

  156. Fujii K, Lenkey C, Rhoton Jr AL (1980) Microsurgical anatomy of the choroidal arteries. Fourth ventricle and cerebellopontine angles. J Neurosurg 52:504–24.

    Article  PubMed  CAS  Google Scholar 

  157. Lister JR, Rhoton Jr AL, Matsushima T, et al. (1982) Microsurgical anatomy of the posterior inferior cerebellar artery. Neurosurgery 10:170–99.

    Article  PubMed  CAS  Google Scholar 

  158. Cullen SP, Ozanne A, Alvarez H, et al. (2005) The bihemispheric posterior inferior cerebellar artery. Neuroradiology 47:809–12.

    Article  PubMed  Google Scholar 

  159. Ogawa T, Fujita H, Inugami A, et al. (1991) Anomalous origin of the posterior inferior cerebellar artery from the posterior meningeal artery. AJNR Am J Neuroradiol 12:186.

    PubMed  CAS  Google Scholar 

  160. Manabe H, Oda N, Ishii M, et al. (1991) The posterior inferior cerebellar artery originating from the internal carotid artery, associated with multiple aneurysms. Neuroradiology 33:513–5.

    Article  PubMed  CAS  Google Scholar 

  161. Ahuja A, Graves VB, Crosby DL, et al. (1992) Anomalous origin of the posterior inferior cerebellar artery from the internal carotid artery. AJNR Am J Neuroradiol 13:1625–6.

    PubMed  CAS  Google Scholar 

  162. Theodosopoulos PV, Lawton MT (2000) Fenestration of the posteroinferior cerebellar artery: case report. Neurosurgery 47:463–5.

    Article  PubMed  CAS  Google Scholar 

  163. Tanohata K, Maehara T, Noda M, et al. (1987) Anomalous origin of the posterior meningeal artery from the lateral medullary segment of the posterior inferior cerebellar artery. Neuroradiology 29:89–92.

    Article  PubMed  CAS  Google Scholar 

  164. Lesley WS, Rajab MH, Case RS (2007) Double origin of the posterior inferior cerebellar artery: association with intracranial aneurysm on catheter angiography. AJR Am J Roentgenol 189:893–7.

    Article  PubMed  Google Scholar 

  165. Kwon BJ, Jung C, Im SH, et al. (2007) Double origin of the posteroinferior cerebellar artery: angiographic anatomy and endovascular treatment of concurrent vertebrobasilar dissection. Neurosurgery 61:242–7 [discussion 7-8].

    Article  PubMed  Google Scholar 

Download references

Authors
  1. M. Bruneau
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. O. De Witte
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. L. Regli
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. B. George
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer-Verlag France, Paris

About this chapter

Cite this chapter

Bruneau, M., De Witte, O., Regli, L., George, B. (2011). Anatomical variations. In: Pathology and surgery around the vertebral artery. Springer, Paris. https://doi.org/10.1007/978-2-287-89787-0_7

Download citation

  • DOI: https://doi.org/10.1007/978-2-287-89787-0_7

  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-287-89786-3

  • Online ISBN: 978-2-287-89787-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation