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C2 Segmental-Type Vertebral Artery Diagnosed Using Computed Tomographic Angiography.

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PubMed
Summary
This summary is machine-generated.

The C2 segmental-type vertebral artery (VA) is a rare anatomical variation. Its association with the ipsilateral VAs coursing suboccipitally (IVASO) and posterior inferior cerebellar artery (PICA) origin influences infarction outcomes.

Keywords:
Computed tomography angiographyCongenital abnormalitiesInfarctionVertebral artery

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Area of Science:

  • Anatomy
  • Vascular Neurology
  • Radiology

Background:

  • A C2 segmental-type vertebral artery (VA) enters the spinal canal via the C1-2 intervertebral space.
  • This anatomical variation requires detailed description and understanding of its clinical significance.

Purpose of the Study:

  • To describe the anatomy of the C2 segmental-type VA.
  • To review the clinical importance and associated vascular variations of the C2 segmental-type VA.
  • To analyze the origin of the ipsilateral posterior inferior cerebellar artery (PICA) in relation to C2 segmental-type VAs.

Main Methods:

  • Computed tomographic angiography (CTA) was performed on 3386 patients between March 2014 and November 2015.
  • Identified C2 segmental-type VAs, associated vascular variations, PICA origins (categorized into 5 types), and clinical symptoms.
  • Type 1 PICA: originates from ipsilateral VAs coursing suboccipitally (IVASO). Type 2: originates from ipsilateral proximal C2 segmental-type VAs. Type 3: originates from ipsilateral distal C2 segmental-type VAs. Type 4: PICA does not originate from an ipsilateral VA. Type 5: PICA is the terminal end of an ipsilateral C2 segmental-type VA.

Main Results:

  • 121 C2 segmental-type VAs were identified in 113 patients.
  • 47 C2 segmental-type VAs were associated with IVASO, while 74 were not.
  • PICA origins included: 4 type 1, 13 type 2, 60 type 3, 42 type 4, and 2 type 5.
  • Only one patient presented with symptoms, a C2 segmental-type VA infarction.

Conclusions:

  • The presence of ipsilateral IVASO and the origin of the PICA are crucial factors in predicting outcomes of C2 segmental-type VA infarction.
  • Understanding these vascular variations is important for managing patients with C2 segmental-type VAs.