scholarly journals ANOMALOUS PREVERTEBRAL COURSE OF THE LEFT VERTEBRAL ARTERY. Recorrido prevertebral anómalo de la arteria vertebral izquierda

2016 ◽  
Vol 6 (3) ◽  
pp. 176-179
Author(s):  
Prakash B Billakanti
Keyword(s):  
Vertebral Artery ◽  
Present Report ◽  
Left Vertebral Artery ◽  
Thoracic Region ◽  
Developmental Mechanism ◽  
Arch Of The Aorta ◽  
The Right ◽  
The Brain ◽  
Variant Anatomy ◽  
Insight Into

La arteria vertebral es una de las arterias que irriga el cerebro. El conocimiento de la anatomía normal y las variantes de la arteria vertebral adquiere importancia en la práctica clínica y la radiología vascular. El origen anómalo de la arteria vertebral del arco de la aorta o cualquiera de las arterias del cuello ha sido reportado por muchos autores. En este informe se presenta una variación del curso prevertebral de la arteria vertebral izquierda. La arteria vertebral tenía su origen habitual en la arteria subclavia con un largo curso prevertebral y entraba en el foramen transversarium de la vértebra CII. El origen y recorrido de la arteria vertebral en el lado derecho fue normal. Clínicamente es importante conocer el origen y curso del segmento prevertebral de la arteria vertebral y las posibles variaciones. El presente informe debería ser de interés para el médico vascular con respecto a las variaciones en el cuello y región torácica, y puede dar idea para dilucidar el mecanismo de desarrollo de la angiogénesis. Vertebral artery is one of the arteries supplying the brain. Knowledge of the normal and variant anatomy of the vertebral artery assumes importance in clinical practice and vascular radiology. Anomalous origins of the vertebral artery from the arch of the aorta or any one of the arteries of the neck have been reported by several authors. In this report a variation of the prevertebral course of the left vertebral artery is being presented. The Vertebral artery had usual origin from the subclavian artery and had a longer prevertebral course to enter the foramen transversarium of the CII vertebra. The origin and course of the vertebral artery on the right side was normal. It is clinically important to know the origin and course of the prevertebral segment of the vertebral artery and possible variations. The present report should be of interest for clinicians with regard to vascular variations in the neck and thoracic region, and may give insight into elucidating the developmental mechanism of angiogenesis.

scholarly journals Endovascular treatment of a patient with traumatic dissection lesions of both vertebral arteries obtained during chiropractic manipulation

2018 ◽  
Vol 24 (2) ◽  
pp. 77-86
Author(s):  
Yu.V. Cherednychenko ◽  
A.Yu. Miroshnychenko ◽  
L.A. Dzyak ◽  
N.A. Zorin ◽  
S.P. Grygoruk ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Vertebral Artery ◽  
Cerebral Angiography ◽  
Left Vertebral Artery ◽  
Chiropractic Manipulation ◽  
Vertebral Arteries ◽  
Coordination Disorders ◽  
Cerebellar Artery ◽  
The Right ◽  
The Brain

The observation of endovascular treatment of a 34-year-old woman with bilateral dissection lesions of vertebral arteries in V4-segments with occlusion of the right vertebral artery and right posterior inferior cerebellar artery, severe stenosis of the left vertebral artery caused by chiropractic manipulation in the neck region is described. There are intensive staticolocomotor and dynamic coordinating insufficiency, severe neck pain, headache, severe dizziness, Wallenberg syndrome, moderate central tetraparesis. MRI of the brain on the DWI Isotropic identified the hyperintensive round-shaped foci in the right hemisphere of the cerebellum, in the right side of cerebellum worm, in the right side of the medulla oblongata and in the right side of the pons (DWI BSS 3). Selective cerebral angiography was performed an hour after the clinic manifestation. Simultaneously, balloon angioplasty of severe dissection stenosis was performed in the V4-segment of the left vertebral artery by the compliant balloon-catheter Scepter C. In 18 hours from the development of vertebral artery dissection, self-expending stent LVIS was implanted into the left vertebral artery in the zone of dissection lesion. On the control angiograms: the left vertebral artery patency is restored without stenosis all along. The stent is fully opened. A second contrast contour is determined outside the stent in the dissection zone. All the arteries of the vertebrobasilar basin above the vertebrobasilar junction are passable. The V4-segment of the right vertebral artery is contrasted through the vertebrobilar junction. There was a rapid regression of neurological symptoms in the postoperative period. Only mild hypoesthesia on the right side in the outer Sölder’s zone, light coordination disorders on the right were remained. Control selective cerebral angiography revealed recanalization of the right vertebral artery and the right posterior cerebellar artery. But distal basin of the right posterior cerebellar artery is very poorly. The left vertebral artery is passable all over, but in the place of the former dissection, two equivalent arterial «sleeves» were formed according to the fenestration type. One «sleeve» is formed by a stent, the other — outside. All arteries of the vertebrobasilar basin are contrasted. The mild hemihepesthesia on the right side of the face in the outer Sölder’s zone, light coordination disorders on the right are remained. Implantation of the self-expanding stent LVIS allowed to restore the dominant vertebral artery and restrict ischemic brain damage in the brain stem and cerebellum in a patient with a both vertebral arteries dissection lesion caused by chiropractic neck manipulations.

scholarly journals Endovascular treatment of tandemic occlusions in acute ischemic stroke

2021 ◽  
Vol 36 (2) ◽  
pp. 73-81
Author(s):  
D.V. Shcheglov ◽  
V.N. Zahorodnii ◽  
S.V. Konotopchik ◽  
A.A. Pastushin
Keyword(s):  
Computed Tomography ◽  
Ischemic Stroke ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Endovascular Treatment ◽  
Vertebral Artery ◽  
Internal Carotid ◽  
Left Vertebral Artery ◽  
The Right ◽  
The Brain

The observation of endovascular treatment of acute tandem occlusion of internal carotid artery (ICA), anterior cerebral artery (ACA) and middle cerebral artery (MCA) in combination with the thrombosis of the right ICA and the critical stenosis of the left vertebral artery is presented.Man, 61 years old. He was delivered to the Center of endovascular neuroradiology, NAMS of Ukraine on January 15, 2021 with an ischemic stroke clinic in the left internal carotid artery basin. He fell ill acutely ‒ against the background of complete well-being, sensorimotor aphasia and right-sided hemiplegia appeared. Upon admission on the NIHSS (National Institutes of Health Stroke Scale) ‒ 18 points. On the performed initial multispiral computed tomography of the brain according to ASPECTS (Alberta Stroke Program Early CT score) ‒ 8 points. In the endovascular operating room, cerebral angiography was performed, followed by surgery aimed at restoring cerebral blood flow. The time from the onset of the disease to the puncture was 330 minutes, the duration of the operation was 135 minutes, thus the time from the onset of the disease to reperfusion was 465 minutes. Angiography revealed acute thrombosis of the left ICA starting from the orifice, M1-segment of the left MCA and A2-segment of the left ACA. Partial compensation of the basin through the supra-block anastomosis (external carotid artery ‒ ICA), as well as from the vertebro-basilar system through the network of leptomeningeal arteries. Collaterals ‒ ACG 3. Thrombosis of the right ICA and critical stenosis (95 %) of the V1-segment of the left vertebral artery were also revealed. The operation was performed ‒ recanalization of thrombosis of the left ICA orifice followed by balloon angioplasty, thrombectomy from the MCA and ACA pools. The end result is eTICI 2c reperfusion. There were no complications during this operation. The patient was discharged the next day (transferred to the neurological department at the place of residence). Control multispiral computed tomography of the brain showed positive dynamics (ASPECTS ‒ 1 point).

scholarly journals Anomalous origin of the left vertebral artery from the arch of the aorta

2021 ◽  
Vol 19 (3) ◽  
pp. 277-279
Author(s):  
Maria Jasiewicz ◽  
◽  
Piotr Sajdak ◽  
Aleksandra Sopel ◽  
Kamil Strzępek ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Endovascular Procedures ◽  
Present Report ◽  
Anomalous Origin ◽  
Left Vertebral Artery ◽  
Female Cadaver ◽  
Arch Of The Aorta ◽  
Rare Anatomic Variant

Introduction. Although there are lots of varieties of aorta arch, they seem to appear relatively rarely. Anomalies of aortic arch departures are mainly concerned with its location, course, the place of departure and number of its main branches. However, they warrant attention due to their importance in operative, diagnostic, and endovascular procedures. Aim. We want to present here a case of a female cadaver with rare aortic arch origin of the left vertebral artery. The aim of this article is to complete the frame of anomalies in aortic arch and to explore rare variability shown in this specific case. Description of the case. The present report describes an anomalous case of the left vertebral artery arising from the aortic arch between the left common carotid artery and the left subclavian artery in a female cadaver during dissection in an anatomical laboratory. Aortic origin of the vertebral artery is a rare anatomic variant. Conclusion. Thorough knowledge of anomalous origin is important for patients who undergo operation of an aortic arch or inferior part of the neck. Normally, the vertebral artery arises from the first part of the subclavian artery on both sides.

Effects of the SNAP25 on Integration Ability of Brain Functions in Children With ADHD

2020 ◽  
pp. 108705472096456
Author(s):  
Yue Yang ◽  
Gang Peng ◽  
Hongwu Zeng ◽  
Diangang Fang ◽  
Linlin Zhang ◽  
...  
Keyword(s):  
Time Window ◽  
Precentral Gyrus ◽  
Children With Adhd ◽  
Brain Functions ◽  
Lingual Gyrus ◽  
Window Method ◽  
Central Gyrus ◽  
The Right ◽  
The Brain ◽  
Insight Into

Objective: The present study aimed to examine the effects of SNAP25 on the integration ability of intrinsic brain functions in children with ADHD, and whether the integration ability was associated with working memory (WM). Methods: A sliding time window method was used to calculate the spatial and temporal concordance among five rs-fMRI regional indices in 55 children with ADHD and 20 healthy controls. Results: The SNAP25 exhibited significant interaction effects with ADHD diagnosis on the voxel-wise concordance in the right posterior central gyrus, fusiform gyrus and lingual gyrus. Specifically, for children with ADHD, G-carriers showed increased voxel-wise concordance in comparison to TT homozygotes in the right precentral gyrus, superior frontal gyrus, postcentral gyrus, and middle frontal gyrus. The voxel-wise concordance was also found to be related to WM. Conclusion: Our findings provided a new insight into the neural mechanisms of the brain function of ADHD children.

scholarly journals Morphology of the vertebral artery in Asian population

2014 ◽  
Vol 5 (4) ◽  
pp. 84-88 ◽  
Author(s):  
Maryna Alfaouri-Kornieieva ◽  
Azmy M Al-Hadidi
Keyword(s):  
Vertebral Artery ◽  
Asian Population ◽  
Outer Diameter ◽  
Medical Sciences ◽  
The Third ◽  
Asian Patients ◽  
Distal Loop ◽  
The Right ◽  
Occipital Lobes ◽  
The Brain

Background: Recent clinical trials have shown a rising trend of stroke in Asian population. Approximately 20% strokes of total occur at the vertebrobasilar basin that supplies the occipital lobes of the brain, the cerebellum, and the brainstem. The anatomical features and variability of the third segment of the vertebral artery (VA) in Asians are analyzed in this study. Methods: A prospective cohort study of 68 consecutive Asian patients underwent MRA examination for head and neck in the Department of Radiology of Hospital of University of Jordan from 1.10.2011 to 30.04.2012. The 116 VA were analyzed on the obtained angiograms. Results: The third segment (V3) of the VA was studied according to its conventional division into vertical, horizontal, and oblique parts. The mean outer diameter of the V3 varied up 3.18 ± 0.73 to 4.28 ± 1.08 mm. The parameter prevailed on the left in 91% cases and was greater in males, than in females. The distal loop of the VA projected downward in 26 cases on the right (78%) and in 28 cases on the left (74%). The tortuosity of loop?formations of V3 was evaluated subject to angles between their ascending and descending bends. Conclusion: In comparison with other ethnic groups, the V3 of the VA in Asians has lesser outer diameter, especially along its oblique part; the zero?distance between the occipital bone and horizontal segment of VA occurs more often (up to 26%); the Lang’s III type of V3 variability is the most common in Asians. DOI: http://dx.doi.org/10.3126/ajms.v5i4.6150 Asian Journal of Medical Sciences 2014 Vol.5(4); 84-88

scholarly journals Progressive cervicocranial arteriopathy with dilatations and stenoses: case report

2004 ◽  
Vol 62 (3b) ◽  
pp. 899-902 ◽  
Author(s):  
Adriana Bastos Conforto ◽  
Paulo Puglia Jr ◽  
Fábio Iuji Yamamoto ◽  
Milberto Scaff
Keyword(s):  
Vertebral Artery ◽  
Carotid Arteries ◽  
Fibromuscular Dysplasia ◽  
Internal Carotid ◽  
Left Vertebral Artery ◽  
Fusiform Aneurysm ◽  
Pathogenetic Mechanism ◽  
Pontine Infarction ◽  
The Right ◽  
Internal Carotid Arteries

We report the case of a 36 year-old woman who presented occlusion of a basilar artery fusiform aneurysm (FA) associated with pontine infarction, and two episodes of subarachnoid hemorrhage possibly due to arterial dissection. She also had asymptomatic FAs in the right middle cerebral and left internal carotid arteries. Over 5 years, lesions suggestive of fibromuscular dysplasia in the right vertebral artery and occlusion of the left vertebral artery were observed. This combination of lesions emphasizes the possibility of a common pathogenetic mechanism causing different degrees of media disruption in cervicocranial arteries.

scholarly journals Direct puncture of the V3 segment of the vertebral artery in acute basilar artery stroke: an alternative approach in desperate circumstances

2019 ◽  
Vol 12 (8) ◽  
pp. e231335 ◽  
Author(s):  
Sean Thomas O’Reilly ◽  
Ian Rennie ◽  
Jim McIlmoyle ◽  
Graham Smyth
Keyword(s):  
Vertebral Artery ◽  
Basilar Artery ◽  
Posterior Inferior Cerebellar Artery ◽  
Left Vertebral Artery ◽  
Basilar Artery Thrombosis ◽  
Direct Puncture ◽  
Alternative Approach ◽  
Cerebellar Artery ◽  
First Pass ◽  
The Right

A patient in his mid-40s presented with acute basilar artery thrombosis 7 hours postsymptom onset. Initial attempts to perform mechanical thrombectomy (MT) via the femoral and radial arterial approaches were unsuccessful as the left vertebral artery (VA) was occluded at its origin and the right VA terminated in the posterior inferior cerebellar artery territory, without contribution to the basilar system. MT was thus performed following ultrasound-guided direct arterial puncture of the left VA in its V3 segment, with antegrade advancement of a 4 French radial access sheath. First pass thrombolyisis in cerebral infarction (TICI) 3 recanalisation achieved with a 6 mm Solitaire stent retriever and concurrent aspiration on the 4 French sheath. Vertebral closure achieved with manual compression.

Bow Hunter's Syndrome: Complete Microsurgical Decompression of Vertebral Artery by Far Lateral Retrocondylar Approach: 3-Dimensional Operative Video

2019 ◽  
Author(s):  
Qazi Zeeshan ◽  
Juan P Carrasco Hernandez ◽  
Laligam N Sekhar
Keyword(s):  
Vertebral Artery ◽  
Nerve Root ◽  
Dynamic Compression ◽  
Skin Incision ◽  
Left Vertebral Artery ◽  
Occipital Condyle ◽  
Cerebral Angiogram ◽  
Microsurgical Decompression ◽  
C2 Nerve Root ◽  
The Right

Abstract This 50-yr-old man had a 15-yr history of presyncopal episodes that were precipitated by turning his head to the right, and had worsened recently. Cerebral angiogram demonstrated complete cessation of anterograde flow in left vertebral artery (VA) at the level of the C1 sulcus arteriosus while turning head to right, indicating dynamic compression at the C1 level.  Patient underwent left extreme lateral retrocondylar approach, partial C1 laminectomy and opening of the C1 foramen with complete microsurgical decompression of the VA. After skin incision, meticulous muscle dissection was performed and superior and inferior oblique muscles were disconnected from the tubercle of C1. The VA was exposed, and three areas of constriction were visible, first at the atlanto-occipital membrane laterally; second, located more medially as the artery curved around the occipital condyle to enter the posterior fossa; and third, located anterior to C2 nerve root. The artery was dissected from all the surrounding tissues, preserving the C2 nerve root, and the Cl foramen was opened completely. The Cl lamina was also partially resected and grooved to allow free placement of the VA. The VA was also decompressed near the C2 foramen. Postoperative computed tomography angiogram of the head and neck showed complete decompression of VA. The patient had no episodes of presyncope or dizziness while turning head to right and his mRs was 0 at 8 mo follow up.  This 3D video shows the technical nuances of decompression of V3 segment of VA in bow hunters's syndrome.  Informed consent was obtained from the patient prior to the surgery that included videotaping of the procedure and its distribution for educational purposes. All relevant patient identifiers have also been removed from the video and accompanying radiology slides.

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