open access
A case of a single intracranial vertebral artery and cerebral infarct
open access
Abstract
The vertebral arteries are commonly affected by anatomical variation. This variation ranges from slight asymmetry in arterial diameter between the right and left sides to complete absence of a vertebral artery on one side. Asymmetry in diameter is a common observation, although complete absence of the artery is rare. Herein, we report on a 79-year-old male anatomical donor who, upon brain removal, was found to have a single intracranial vertebral artery which was the sole source of the basilar artery. During dissection of the neck, both right and left vertebral arteries were identified arising from the subclavian arteries. The vertebral arteries were dissected from the transverse foramina and followed into the skull. The right vertebral artery terminated by supplying the spinal cord, consistent with the distribution of the posterior spinal artery. Such vascular anomalies are clinically significant, as they may lead to abnormal patterns of sensory-motor deficiencies in stroke and are at risk of iatrogenic injury during surgical procedures.
Abstract
The vertebral arteries are commonly affected by anatomical variation. This variation ranges from slight asymmetry in arterial diameter between the right and left sides to complete absence of a vertebral artery on one side. Asymmetry in diameter is a common observation, although complete absence of the artery is rare. Herein, we report on a 79-year-old male anatomical donor who, upon brain removal, was found to have a single intracranial vertebral artery which was the sole source of the basilar artery. During dissection of the neck, both right and left vertebral arteries were identified arising from the subclavian arteries. The vertebral arteries were dissected from the transverse foramina and followed into the skull. The right vertebral artery terminated by supplying the spinal cord, consistent with the distribution of the posterior spinal artery. Such vascular anomalies are clinically significant, as they may lead to abnormal patterns of sensory-motor deficiencies in stroke and are at risk of iatrogenic injury during surgical procedures.
Keywords
anatomical variation, basilar artery, congenital anomaly
About this articleTitle
A case of a single intracranial vertebral artery and cerebral infarct
Journal
Issue
Article type
Case report
Pages
134-138
Published online
2016-06-08
Page views
1703
Article views/downloads
2007
DOI
Pubmed
Bibliographic record
Folia Morphol 2017;76(1):134-138.
Keywords
anatomical variation
basilar artery
congenital anomaly
Authors
K. Blackburn
L. Labranche
J. Kalmey
R. Kulesza
References (18)1. Adachi B. Das Arteriensystem der Japaner. Vol. I. Maruzen, Kyoto, Tokyo 1928.
- Batujeff N. Eine seltene arterienanomalie. Ursprung der a basilaris aus der a carotis internal. Anat Anz. 1889; 4: 282.
- Berry RJ. case of nonunion of the vertebrales with consequent abnormal origin of the basilaris. Anat Anz. 1910; 35: 54–65.
- Chuang YM, Huang YC, Hu HH, et al. Toward a further elucidation: role of vertebral artery hypoplasia in acute ischemic stroke. Eur. Neurol. 2006; 55(4): 193–197.
- Ergun O, Gunes Tatar I, Birgi E, et al. Evaluation of vertebral artery dominance, hypoplasia and variations in the origin: angiographic study in 254 patients. Folia Morphol. (Warsz). 2016; 75(1): 33–37.
- Giuffrè R, Sherkat S. Maldevelopmental pathology of the vertebral artery in infancy and childhood. Childs Nerv Syst. 2000; 16(10-11): 627–632.
- Hong JM, Chung CS, Bang OY, et al. Vertebral artery dominance contributes to basilar artery curvature and peri-vertebrobasilar junctional infarcts. J Neurol Neurosurg Psychiatr. 2009; 80(10): 1087–1092.
- Koenigsberg RA, Pereira L, Nair B, et al. Unusual vertebral artery origins: examples and related pathology. Catheter Cardiovasc Interv. 2003; 59(2): 244–250.
- Krayenbuhl H, Yasargil MG. [The vascular diseases in the region of the basilar and vertebral arteries; an anatomopathological, clinical and neuroradiological study]. Fortschr Geb Rontgenstr Nuklearmed. 1957; 87(Ergbd. 80): 1–170.
- Morris SA, Orbach DB, Geva T, et al. Increased vertebral artery tortuosity index is associated with adverse outcomes in children and young adults with connective tissue disorders. Circulation. 2011; 124(4): 388–396.
- Perren F, Poglia D, Landis T, et al. Vertebral artery hypoplasia: a predisposing factor for posterior circulation stroke? Neurology. 2007; 68(1): 65–67.
- Sańudo J, Vázquez R, Puerta J. Meaning and clinical interest of the anatomical variations in the 21st century. Eur J Anat. 2003; 7(suppl. 1): 1–3.
- Satti SR, Cerniglia CA, Koenigsberg RA. Cervical vertebral artery variations: an anatomic study. AJNR Am J Neuroradiol. 2007; 28(5): 976–980.
- Seidel E, Eicke BM, Tettenborn B, et al. Reference values for vertebral artery flow volume by duplex sonography in young and elderly adults. Stroke. 1999; 30(12): 2692–2696.
- Shoja M, Tubbs R, Khaki A, et al. rare variation of the vertebral artery. Folia Morphol. 2006; 65: 167–170.
- Tetiker H, Çimen M, Kosar M. Evaluation of the Vertebral Artery by 3D Digital Subtraction Angiography. International Journal of Morphology. 2014; 32(3): 798–802.
- Thierfelder KM, Baumann AB, Sommer WH, et al. Vertebral artery hypoplasia: frequency and effect on cerebellar blood flow characteristics. Stroke. 2014; 45(5): 1363–1368.
- Wang S, Wang C, Liu Yi, et al. Anomalous vertebral artery in craniovertebral junction with occipitalization of the atlas. Spine. 2009; 34(26): 2838–2842.
