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Abnormal course of the vertebral artery at the craniovertebral junction in patients with Down syndrome visualized by three-dimensional CT angiography

  • Diagnostic Neuroradiology
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Abstract

Introduction

We determined the incidence of vertebral artery (VA) anomalies at the craniovertebral junction (CVJ) in patients with Down syndrome, and characterized the VA anomalies.

Methods

The course of the VA in 46 consecutive patients who were due to undergo posterior arthrodesis surgery at the CVJ were evaluated by three-dimensional CT angiography (3DCTA). Included were five patients with Down syndrome who suffered from myelopathy due to atlantoaxial subluxation. All five patients with Down syndrome also had a simultaneous congenital skeletal anomaly, either os odontoideum or ossiculum terminale.

Results

Of the five patients with Down syndrome, three had VA anomalies at the CVJ, two had fenestration and one had a persistent first intersegmental artery. Of the other 41 patients without Down syndrome, five had VA anomalies at the CVJ. The incidence of VA anomalies at the CVJ was much higher in patients with Down syndrome than in those without Down syndrome.

Conclusion

In planning surgery in patients with Down syndrome with symptomatic atlantoaxial subluxation and a congenital skeletal anomaly at the CVJ, we should consider the possible presence of VA anomalies. Preoperative 3DCTA allows us to precisely identify an anomalous VA and evaluate the possible risk of intraoperative VA injury in advance.

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Conflict of interest statement

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Spine Section, Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260–8677, Japan

    Masashi Yamazaki, Akihiko Okawa, Mitsuhiro Hashimoto, Atsuomi Aiba, Yukio Someya & Masao Koda

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  1. Masashi Yamazaki
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  2. Akihiko Okawa
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  3. Mitsuhiro Hashimoto
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  4. Atsuomi Aiba
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  5. Yukio Someya
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  6. Masao Koda
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Corresponding author

Correspondence to Masashi Yamazaki.

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Yamazaki, M., Okawa, A., Hashimoto, M. et al. Abnormal course of the vertebral artery at the craniovertebral junction in patients with Down syndrome visualized by three-dimensional CT angiography. Neuroradiology 50, 485–490 (2008). https://doi.org/10.1007/s00234-008-0368-8

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  • DOI: https://doi.org/10.1007/s00234-008-0368-8

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