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Published on: September 25, 2009
Dual origin of the left vertebral artery: extracranial MRA and CTA findings
W Oliver Tobin1, Ronan Killeen, Justin A Kinsella
1Department of Neurology, The Adelaide and Meath Hospital, Trinity College Dublin, Ireland.
Insights
A rare anatomical variant, a duplicate left vertebral artery origin, was identified in a patient with posterior circulation stroke. Non-invasive imaging is crucial for detecting such variations and understanding stroke causes.
Area of Science:
- Neurology
- Vascular Imaging
- Anatomy
Background:
- Posterior circulation stroke can result from vertebral artery stenosis.
- Atherosclerosis is a common cause of vertebral artery stenosis.
Observation:
- A 48-year-old man experienced a stroke due to left lateral medullary infarction.
- Contrast-enhanced magnetic resonance angiography (CEMRA) showed 40-45% left vertebral artery stenosis.
- CEMRA and CT angiography revealed a rare duplicate origin of the left vertebral artery.
Findings:
- The identified duplicate vertebral artery origin is a rare anatomical variant.
- This variant may contribute to stroke etiology.
- Non-invasive vascular imaging is advantageous before invasive procedures.
Implications:
- Recognizing rare anatomical variants like duplicate vertebral arteries is critical in stroke cases.
- Understanding these variants aids in accurate diagnosis and treatment planning.
- Non-invasive imaging techniques are valuable for pre-procedural assessment in cerebrovascular disease.
Abstract:
A 48-year-old man presented with a posterior circulation stroke secondary to left lateral medullary infarction. Contrast-enhanced magnetic resonance angiography (CEMRA) revealed 40-45% intracranial left vertebral artery stenosis, likely atherosclerotic in nature. CEMRA and subsequent computed tomography angiography also identified a duplicate origin of the left vertebral artery. The importance of recognition of this rare anatomical variant, its potential contribution to stroke aetiology, and the advantage of non-invasive vascular imaging prior to catheter angiography is emphasised.
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