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Case report
Submitted: 2020-06-05
Accepted: 2020-07-20
Published online: 2021-03-02
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Fenestration of the vertebrobasilar junction detected with multidetector computed tomography angiography

B. R. Omotoso1, R. Harrichandparsad2, I. G. Moodley3, K. S. Satyapal1, L. Lazarus1
DOI: 10.5603/FM.a2021.0028
·
Pubmed: 33749807
Affiliations
  1. Department of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Westville Campus, Durban, South Africa
  2. Department of Neurosurgery, School of Clinical Medicine, College of Health Sciences, University of KwaZulu Natal, South Africa
  3. Department of Radiology, Jackpersad and Partners Inc., Specialist Diagnostic Radiologists, Lenmed Ethekwini Hospital and Heart Centre, South Africa

open access

Ahead of Print
CASE REPORTS
Submitted: 2020-06-05
Accepted: 2020-07-20
Published online: 2021-03-02

Abstract

The complex embryonic origin of the vertebrobasilar system may result in a wide range of anatomical variations. It has been hypothesized that the formation of fenestrations are likely to occur due to the failure of regression of the bridging arteries that connect the longitudinal neural arteries during embryogenesis. Fenestration of the vertebrobasilar system is a rare anatomical variation that involves a luminal division of the artery, that has a single origin into two separate and parallel channels which are rejoined distally. Fenestrations are important anatomical variants in patients undergoing endovascular and invasive intracranial interventions. Vascular fenestration has been associated with aneurysms, arteriovenous malformations, neuralgia, and vertebrobasilar ischemia. We report on three cases of fenestration at the vertebrobasilar junction in one female and two male patients, respectively, using multidetector computed tomography angiography. The length of the fenestrated segment of the artery measured 4.41 mm, 3.90 mm, and 5.90 mm, respectively in the patients. Our report is clinically important as the presence of this anatomical variation may influence the management of cervical and intracranial pathologies. Increased awareness of the prevalence of anatomic variations contributes to the advancement of noninvasive imaging capabilities.

Abstract

The complex embryonic origin of the vertebrobasilar system may result in a wide range of anatomical variations. It has been hypothesized that the formation of fenestrations are likely to occur due to the failure of regression of the bridging arteries that connect the longitudinal neural arteries during embryogenesis. Fenestration of the vertebrobasilar system is a rare anatomical variation that involves a luminal division of the artery, that has a single origin into two separate and parallel channels which are rejoined distally. Fenestrations are important anatomical variants in patients undergoing endovascular and invasive intracranial interventions. Vascular fenestration has been associated with aneurysms, arteriovenous malformations, neuralgia, and vertebrobasilar ischemia. We report on three cases of fenestration at the vertebrobasilar junction in one female and two male patients, respectively, using multidetector computed tomography angiography. The length of the fenestrated segment of the artery measured 4.41 mm, 3.90 mm, and 5.90 mm, respectively in the patients. Our report is clinically important as the presence of this anatomical variation may influence the management of cervical and intracranial pathologies. Increased awareness of the prevalence of anatomic variations contributes to the advancement of noninvasive imaging capabilities.

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Keywords

morphological variation, vertebral artery, basilar artery

About this article
Title

Fenestration of the vertebrobasilar junction detected with multidetector computed tomography angiography

Journal

Folia Morphologica

Issue

Ahead of Print

Article type

Case report

Published online

2021-03-02

Page views

510

Article views/downloads

457

DOI

10.5603/FM.a2021.0028

Pubmed

33749807

Keywords

morphological variation
vertebral artery
basilar artery

Authors

B. R. Omotoso
R. Harrichandparsad
I. G. Moodley
K. S. Satyapal
L. Lazarus

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