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Abdominal Aorta01:25

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Once the aorta traverses the diaphragmatic plane at the aortic hiatus, it is known as the abdominal aorta. This anatomical structure is positioned leftward of the spinal column, encased within a cocoon of adipose tissue behind the peritoneal cavity. It terminates at the L4 vertebra, where it splits into the common iliac arteries. Prior to this bifurcation, the abdominal aorta gives rise to several vital branches.
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The thoracic section of the aorta begins at the T5 vertebra and extends to the T12 level at the diaphragm, initially progressing through the mediastinum to the left of the spinal column. Throughout its course in the thoracic segment, the thoracic aorta emits various offshoots known collectively as visceral and parietal branches. The branches that predominantly supply blood to visceral organs are termed visceral branches and include bronchial, pericardial, esophageal, and mediastinal arteries,...
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Atlantoaxial Instability with Persistent Second Intersegmental Artery.

Batuk Diyora1, Ravi Wankhade1, Kavin Devani1

  • 1Department of Neurosurgery, Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, Maharashtra, India.

Asian Journal of Neurosurgery
|January 1, 2024
PubMed
Summary
This summary is machine-generated.

Congenital atlantoaxial dislocation can cause vertebral artery injury. Surgical management involving vertebral artery mobilization, guided by CT angiography, significantly improved a patient's condition.

Keywords:
3D CTCT angiographyOs odontoideumatlantoaxial instabilityvertebral artery

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Area of Science:

  • Neurosurgery
  • Vascular Anatomy
  • Pediatric Orthopedics

Background:

  • The craniovertebral junction's anatomy, particularly the vertebral artery, is critical for surgical procedures.
  • Congenital atlantoaxial dislocation presents unique challenges due to anomalous vertebral artery courses, increasing injury risk.
  • Preoperative computed tomography (CT) angiography is vital for identifying vertebral artery anomalies and surgical planning.

Observation:

  • A 13-year-old boy with a year of neck pain and spastic quadriparesis.
  • Radiological imaging confirmed atlantoaxial instability with basilar invagination.
  • CT angiography revealed an anomalous vertebral artery course attributed to a persistent second intersegment artery.

Findings:

  • Successful posterior atlantoaxial fixation was performed after careful mobilization of the anomalous vertebral artery.
  • The patient experienced significant clinical improvement post-surgery.

Implications:

  • This case highlights the importance of recognizing and managing vertebral artery anomalies in congenital atlantoaxial dislocation.
  • Vertebral artery mobilization is a crucial technique for preventing intraoperative injury during craniovertebral junction surgery.
  • CT angiography is indispensable for preoperative assessment and surgical strategy in complex craniovertebral anomalies.