open access

Vol 77, No 4 (2018)
Original article
Submitted: 2018-01-17
Accepted: 2018-03-14
Published online: 2018-04-10
Get Citation

Variability of the vertebral artery origin and transverse foramen entrance level — CT angiographic study

S. Vujmilović1, G. Spasojević2, S. Vujnović1, S. Malobabić3, Z. Vujković4
·
Pubmed: 29651795
·
Folia Morphol 2018;77(4):687-692.
Affiliations
  1. University of Banja Luka , Faculty of Medicine , Department of Clinical Radiology, Dvaneast beba, 78000 Banja Luka, Bosnia and Herzegovina
  2. Department of Radiology, Faculty of Medicine, University Clinical Centre of Republic Srpska, University of Banja Luka, Bosnia and Herzegovina
  3. Institute of Anatomy, Dr Subotića 4, 11000 Belgrade, Serbia and Montenegro
  4. University of Banja Luka, Faculty of Medicine, Clinica of Neurology, Clinical Centre of Republic of Srpska, Dvanest beba, 78000 Banja Luka, Bosnia and Herzegovina

open access

Vol 77, No 4 (2018)
ORIGINAL ARTICLES
Submitted: 2018-01-17
Accepted: 2018-03-14
Published online: 2018-04-10

Abstract

Background: Vertebral artery (VA), the main element of the posterior brain circulation, has many anatomical variations which generally were widely investigated. However, available data vary in wide ranges, reflecting very different sample sizes, lack of data about left-right or sex differences, and about possible ethnic, regionally specific or genetic differences.

Materials and methods: Certain new findings suggest possible involvement of some environmental factors in VA variations. Accurate anatomical data about VA variations in different regions of the world, including Balkans countries, are still lacking. Therefore we investigated morphological variability of VA origin and its entrance level into cervical transverse foramina in population of Republika Srpska (Bosnia and Herzegovina), including data about the sex and side.

Results: Anatomy of VA was investigated in 112 persons (224 arteries) of both sexes (58 males, 54 females; age 19–83 years), using 64-slice computed tomography (CT) scanner. Origin of VA from subclavian artery (SCA) we found in 95.08% of arteries (52 males, 49 females). Only in 1 (0.45%) male left VA and left SCA had an specific origin from aortic arch (AA), which we named as an “common area of origin”. All other observed variations in origin were only of left VA, originating from AA in 4.47% (5 males, 5 females). Left VA most often (usual) entrance level into transverse foramen we found at C6 (87.5%), followed by C5 (8.93%), C4 (3.12%), and in 1 case at level C7 (0.45%). Entry levels at C5, both on right and on the left side, were three times more frequent in males than in females.

Conclusions: Wide ranges of differences between the data we obtained on a sample in Republika Srpska (Bosnia and Herzegovina) and the data from many other studies require further and wider investigations.

Abstract

Background: Vertebral artery (VA), the main element of the posterior brain circulation, has many anatomical variations which generally were widely investigated. However, available data vary in wide ranges, reflecting very different sample sizes, lack of data about left-right or sex differences, and about possible ethnic, regionally specific or genetic differences.

Materials and methods: Certain new findings suggest possible involvement of some environmental factors in VA variations. Accurate anatomical data about VA variations in different regions of the world, including Balkans countries, are still lacking. Therefore we investigated morphological variability of VA origin and its entrance level into cervical transverse foramina in population of Republika Srpska (Bosnia and Herzegovina), including data about the sex and side.

Results: Anatomy of VA was investigated in 112 persons (224 arteries) of both sexes (58 males, 54 females; age 19–83 years), using 64-slice computed tomography (CT) scanner. Origin of VA from subclavian artery (SCA) we found in 95.08% of arteries (52 males, 49 females). Only in 1 (0.45%) male left VA and left SCA had an specific origin from aortic arch (AA), which we named as an “common area of origin”. All other observed variations in origin were only of left VA, originating from AA in 4.47% (5 males, 5 females). Left VA most often (usual) entrance level into transverse foramen we found at C6 (87.5%), followed by C5 (8.93%), C4 (3.12%), and in 1 case at level C7 (0.45%). Entry levels at C5, both on right and on the left side, were three times more frequent in males than in females.

Conclusions: Wide ranges of differences between the data we obtained on a sample in Republika Srpska (Bosnia and Herzegovina) and the data from many other studies require further and wider investigations.

Get Citation

Keywords

vertebral artery, anatomy, variations, origin, level, transverse foramina

About this article
Title

Variability of the vertebral artery origin and transverse foramen entrance level — CT angiographic study

Journal

Folia Morphologica

Issue

Vol 77, No 4 (2018)

Article type

Original article

Pages

687-692

Published online

2018-04-10

Page views

5036

Article views/downloads

1098

DOI

10.5603/FM.a2018.0036

Pubmed

29651795

Bibliographic record

Folia Morphol 2018;77(4):687-692.

Keywords

vertebral artery
anatomy
variations
origin
level
transverse foramina

Authors

S. Vujmilović
G. Spasojević
S. Vujnović
S. Malobabić
Z. Vujković

References (24)
  1. Adachi B. Arteriensystem der Japanern, Bd. I, Kenkuysha, Kyoto. 1928: 140–145.
  2. Bhatia K, Ghabriel MN, Henneberg M. Anatomical variations in the branches of the human aortic arch: a recent study of a South Australian population. Folia Morphol. 2005; 64(3): 217–223.
  3. Bergman RA, Afifi AF, Miyauchi R. Vertebral Artery Variations. In: Bergman RA, Afifi AF, Miyauchi R, editors. Illustrated Encyclopedia of Human Anatomic Variation. Opus II: Cardiovascular System. http://www.anatomyatlases.org/AnatomicVariants/Cardiovascular/Images0001/0095.shtml 639.
  4. Bruneau M, Cornelius JF, Marneffe V, et al. Anatomical variations of the V2 segment of the vertebral artery. Neurosurgery. 2006; 59(1 Suppl 1): ONS20–4; discussion ONS20.
  5. Giuffrè R, Sherkat S. Maldevelopmental pathology of the vertebral artery in infancy and childhood. Childs Nerv Syst. 2000; 16(10-11): 627–632.
  6. Henry BM, Tomaszewski KA, Walocha JA. Methods of evidence-based anatomy: a guide to conducting systematic reviews and meta-analysis of anatomical studies. Ann Anat. 2016; 205: 16–21.
  7. Hong JT, Park DK, Lee MJ, et al. Anatomical variations of the vertebral artery segment in the lower cervical spine: analysis by three-dimensional computed tomography angiography. Spine (Phila Pa 1976). 2008; 33(22): 2422–2426.
  8. Hozawa J, Sasaki Y, Watanabe A, et al. Perivascular sympathectomy of the vertebral artery and its effect on the cervicovestibular syndrome. Tohoku J Exp Med. 1973; 109(4): 315–322.
  9. Jayanthi V, Prakash M, Nirmala D, et al. Anomalous origin of the left vertebral artery from the arch of the aorta: review of the literature and a case report. Folia Morphol. 2010; 69(4): 258–260.
  10. Kanaskar N, Vatsalaswamy PA. A study of variations in the origin of vertebral artery and its clinical significance. IJBAR. 2016; 7(5): 247-250. IJBAR. 2016; 7439: 247–250.
  11. Natsis K, Didagelos M, Noussios G, et al. Combined anomalous origin of a left inferior thyroid artery and a left vertebral artery: a case report. Cases J. 2009; 2: 7400.
  12. Rawal J, Jadav H. Anatomical study of variation of vertebral artery entering the foramen transversarium of cervical vertebrae. National J Med Res. 2012; 2(2): 199–201.
  13. Satti SR, Cerniglia CA, Koenigsberg RA. Cervical vertebral artery variations: an anatomic study. AJNR Am J Neuroradiol. 2007; 28(5): 976–980.
  14. Shi-Min Yuan . Aberrant Origin of Vertebral Artery and its Clinical Implications. Braz J Cardiovasc Surg. 2016; 31(1): 52–59.
  15. Sikka A, Jain A. Bilateral variation in the origin and course of the vertebral artery. Anat Res Int. 2012; 2012: 580765.
  16. Simić PB. Bolesti kičme. ( Diseases of the Spine- in Serbian). Obeležja; Beograd. 1999: 386–388.
  17. Singla RK, Sharma T, Sachdeva K. Variant origin of left vertebral artery. Int J Anat Variations. 2010; 3: 97–99.
  18. Sonje P, Arole V, Anand R. Study of variations in the origin and course of of vertebtral artery. Int J Cur Res Rev. 2015; 70(14): 85–90.
  19. Tetiker H, Çimen M, Kosar M. Evaluation of the Vertebral Artery by 3D Digital Subtraction Angiography. Int J Morphol. 2014; 32(3): 798–802.
  20. Vasović Lj, Radenković G, Trandafilović M, et al. et al.. Variable left and/or right vetrtebral artery in prevertebral part: A review of features in the postnatal period. Facta Universitatis. Series: Medicine Biology. 2015; 17(1): 1–25.
  21. Vasović LP. Reevaluation of the morphological parameters according to 11 different duplications of the fetal vertebral artery at prevertebral (V1) and intracranial (V4) parts. Cells Tissues Organs. 2004; 176(4): 195–204.
  22. Vasović L, Jovanović I, Ugrenović S, et al. Extracranial segments of the vertebral atery: insight in the developmental changes up to the 21st year of life. In: Di Rocco C, Akalan N (editors). Pediatric craniovertebral junction diseases. Switzerland Springer Int Publ. 2014: 111–139.
  23. Uchino A, Saito N, Takahashi M, et al. Variations in the origin of the vertebral artery and its level of entry into the transverse foramen diagnosed by CT angiography. Neuroradiology. 2013; 55(5): 585–594.
  24. World Medical Association Declaration Of Helsinki: Ethical Principles for Medical Research Involving Human Subjects, 64th WMA General Assembly, Fortaleza, Brazil, October 2013. https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., Grupa Via Medica, Świętokrzyska 73, 80–180 Gdańsk, Poland

tel.: +48 58 320 94 94, faks: +48 58 320 94 60, e-mail: viamedica@viamedica.pl