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Persistent second cervical intersegmental artery diagnosed by MR angiography.

Akira Uchino1, Naoko Saito1, Shinya Kohyama2

  • 1Department of Diagnostic Radiology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan.

Radiology Case Reports
|June 14, 2019
PubMed
Summary

A rare external carotid and vertebral artery connection was identified, distinct from the typical Type 2 proatlantal artery. This finding represents a persistent second cervical intersegmental artery, offering new insights into vascular anatomy.

Keywords:
Carotid-vertebrobasilar anastomosisCerebral arterial variationExternal carotid arteryVertebral artery

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Area of Science:

  • Vascular anatomy
  • Cranial nerve anatomy
  • Cervical spine vasculature

Background:

  • Anastomosis between the external carotid artery (ECA) and vertebral artery (VA) is exceptionally uncommon.
  • The Type 2 proatlantal artery, a known variant, involves occipital artery-VA anastomosis at the foramen magnum, representing a persistent first cervical intersegmental artery.

Observation:

  • Magnetic resonance angiography was utilized to investigate an unusual arterial connection.
  • The study focused on the cervical spine, specifically the C1 and C2 vertebral levels.

Findings:

  • A direct anastomosis between the external carotid artery and the vertebral artery was observed at the C1-C2 level.
  • This specific anastomosis occurred without any connection involving the occipital artery.

Implications:

  • The identified vessel is diagnosed as a persistent second cervical intersegmental artery, a rare vascular variant.
  • This discovery expands the known spectrum of ECA-VA anastomoses and their embryological origins.
  • Understanding such rare vascular patterns is crucial for neurovascular surgery and diagnostic imaging interpretation.