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Origin and course of the extracranial vertebral artery: CTA findings and embryologic considerations

D Meila1, M Tysiac, M Petersen

  • 1Department of Radiology and Neuroradiology, Klinikum Duisburg-Sana Kliniken, Duisburg, Germany. dan.meila@sana.de

Clinical Neuroradiology
|September 4, 2012
PubMed

Insights

Duplicated vertebral arteries (VA) are rare anomalies, found in 0.74% of patients. While not showing dissection, VA duplication may be linked to intracranial arterial aneurysms, highlighting its clinical significance.

Area of Science:

  • Vascular anatomy and embryology
  • Cerebrovascular imaging
  • Congenital vascular anomalies

Background:

  • The vertebral artery (VA) is crucial for posterior circulation to the brain.
  • Embryological variations in VA development can lead to anomalies.
  • Duplicated VA is a rare anomaly with potential clinical implications.

Purpose of the Study:

  • To delineate the diverse origins and anatomical courses of the extracranial VA using CTA.
  • To emphasize the embryological basis for VA variations.
  • To determine the frequency and clinical significance of duplicated VA.

Main Methods:

  • Retrospective analysis of 539 patient CTAs.
  • Utilized a contrast-enhanced CTA protocol specifically for the VA.
  • Evaluated VA origins, pathways, and foraminal entry levels.

Main Results:

  • Most left VAs originated from the left subclavian artery, entering at C6.
  • A small percentage of left VAs arose from the aortic arch, entering at C4, C5, or C7.
  • Duplicated VA occurred in 0.74% of cases, with a female predominance, and was associated with intracranial aneurysms in two instances.

Conclusions:

  • VA development reflects the persistence of specific segmental metameric arteries.
  • The entry level into the transverse foramen indicates the embryological origin.
  • Duplicated VA, a rare finding, may be associated with vascular lesions like aneurysms.
Abstract

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