Variant course of the vertebral artery
We present a 69 year old female with dizziness. During the evaluation of the carotid we did not found the vertebral artery in the transverse foramina in the middle of the neck. However an artery was traveling side by side with carotid, in the level of the mandible this artery turns and enters the intraspinal foramen.
The right vertebral artery follows a parallel course side by side with the common carotid artery .
Image Va turn:
At the level of the mandible the VA turns and enters the transverse foramen.
Image U l ob:
RIGHT oblique view: The lower segment, thefirst part, of the vertebral artery
LEFT transverse view: The upper segment of the extraspinal vertebral artery before to enter the transverse foramen.
TRA RCC RVA
RIGHT transverse view: The extraspinal vertebral artery before to enter the transverse foramen and the common carotid artery .
LEFT transverse view: the bifurcation of the common carotid artery .
Discussion by Dr Nikos Vougiouklis
The vertebral arteries may present in a number of variant positions. The presence of a vertebral variant must be considered in patients in whom the normal position of the vertebral artery cannot be detected. The vertebral arteries enter the 6th cervical foramen in most cases.
In cases in which the vertebral artery enters of the higher vertebral foramina, the artery may lie directly behind the common carotid artery. In a study by Bergman et al based on 693 laboratory specimens, dual or accessory vertebral arteries were encountered in 5 of 693 specimens, and all were left-sided.
- Koenigsberg RA, Peereira L, Nair B, et al. Unusual vertebral artery origins: examples and related pathology. Catheter CardiovascInterv 2003;59:244–5
- Bergman RA, et al. Opus II: cardiovascular system vertebral artery variations. In: Bergman RA, Afifi AF, Miyauchi R, eds. Illustrated Encyclopedia of Human Anatomic Variation.
Variant course of the vertebral artery Reviewed by Sumer Sethi on Friday, May 25, 2012 Rating: