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.

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