scholarly journals A Rare Variantion of Left Vertebral Artery Originating from External Carotid Artery: A Case Report

2019 ◽  
Vol 4 (1) ◽  
Keyword(s):  
Carotid Artery ◽  
Vertebral Artery ◽  
Cervical Vertebrae ◽  
External Carotid Artery ◽  
Left Vertebral Artery ◽  
External Carotid ◽  
Transverse Foramen ◽  
Vertebral Arteries ◽  
Tomographic Angiography ◽  
Radiological Procedures

Variations of vertebral arteries are congenital anomalies occurring during the embryonic development. We established a variant left vertebral artery which is a branch of left external carotid artery, by using magnetic resonance angiography and computerized tomographic angiography in a 43-year-old female patient whose vertebral arteries could not be detected in Doppler ultrasonography performed for the evaluation of her dizziness. This vertebral artery was extending up outside the transverse foramina until it entered into the left transverse foramen of the cervical vertebrae at the C1 level. Awareness of such variations of vertebral arteries is important with regard to the prevention of possible cerebrovascular injuries in interventional radiological procedures and vascular surgeries. For this reason, we would like to present this rare case of left vertebral artery showing a different origin and course outside the transverse foramina.

Incidental identification of the aberrant origin of left vertebral artery using magnetic resonance angiography: A case report

2021 ◽  
Vol 2 (4) ◽  
Author(s):  
Forough Sodaei ◽  
◽  
Vahid Shahmaei ◽  
Maryam Noroozian ◽  
◽  
...  
Keyword(s):  
Case Report ◽  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Carotid Artery ◽  
Vertebral Artery ◽  
External Carotid Artery ◽  
Left Vertebral Artery ◽  
External Carotid ◽  
Vertebral Arteries ◽  
The Brain

Background: The vertebral arteries originate from the root of the neck as the first branches of the subclavian arteries. Variations of vertebral arteries are congenital anomalies occurring during embryonic development. Anatomic variations of the left vertebral artery are clinically symptomless and recognized incidentally during angiographic assessments or imaging techniques so the diagnosis of these anomalies is a serious challenge. Anomalous origin of vertebral arteries may lead to neurologic disorders. It is, thus, important to identify variations of the large vessels of the aortic arch when planning neck and cervical spine interventions and diagnostic radiology. For this reason, we would like to present this rare case of left vertebral artery showing a different origin. Case report: In this work, we describe a 60-year-old female patient with headache, lethargy and blurred vision. We employed magnetic resonance angiography for both the brain and neck. There was no lesion in the brain. Incidentally, we found that the root of the left vertebral artery was anatomically aberrant. The left vertebral artery arose from the nearest section of the left external carotid artery, next to the bifurcation of the left common carotid artery, which is a rare variation. Conclusion: Understanding the state of anomalous variations of the origin of the vertebral artery might have crucial implications in angiographic and surgical procedures. It is beneficial to perform more screening with noninvasive studies like neck magnetic resonance angiography in clinical cases with potential symptoms coexisting with other diseases in order to predict possible future problems in intracranial and extracranial interventions. Keywords: Vertebral artery; external carotid artery; anatomic variation; magnetic resonance angiography.

scholarly journals Cervical Vertebral Artery to Facial Branch External Carotid Artery Bypass: 2-Dimensional Operative Video

2020 ◽  
Author(s):  
Benjamin K Hendricks ◽  
Robert F Spetzler
Keyword(s):  
Carotid Artery ◽  
Vertebral Artery ◽  
Artery Bypass ◽  
Video Recording ◽  
Distal Segment ◽  
External Carotid Artery ◽  
External Carotid ◽  
Transverse Foramen ◽  
Institutional Review ◽  
V1 Segment

Abstract Posterior circulation ischemia often presents with dizziness, ataxia, visual disturbances, or motor-sensory deficits. The vertebral artery stenosis most frequently involves the V1 segment proximal to the foraminal segment. This patient demonstrated critical stenosis of the left V1 segment of the vertebral artery related to atherosclerotic disease. A left cervical dissection was performed, and the cervical transverse foramen was opened to permit exposure of the vertebral artery in the V2 segment. The vertebral artery was proximally occluded and transected. An endarterectomy was performed, and an end-to-end anastomosis of the facial branch of the external carotid artery to the distal segment of the transected vertebral artery was completed. Indocyanine green angiography was used to confirm patency of the anastomosis. The patient gave informed consent for surgery and video recording. Institutional review board approval was deemed unnecessary. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.

Suspicious Extracranial Duplex Examination: A Predictor of Intracranial Disease?

2009 ◽  
Vol 33 (1) ◽  
pp. 31-35
Author(s):  
Esther Collado ◽  
Megan Hodge ◽  
Charles McCollum ◽  
George Noon ◽  
Ruth L. Bush ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Vertebral Artery ◽  
Moyamoya Disease ◽  
Internal Carotid ◽  
External Carotid Artery ◽  
Left Vertebral Artery ◽  
External Carotid ◽  
Carotid Duplex ◽  
Doppler Signals

Introduction Moyamoya disease is a rare and progressive condition with poor long-term prognosis. A meticulous evaluation during an extracranial carotid duplex exam, with attention to subtle changes in anatomy and Doppler signals, can alert the sonographer to pathology in the intracranial circulation, which may suggest this diagnosis. Case Report A 45-year-old woman presented to our vascular lab with an episode of slurred speech, right arm weakness, right-sided numbness, and generalized weakness that lasted 15 – 20 min, with total resolution of symptoms. A carotid duplex examination was ordered and demonstrated no evidence of extracranial carotid disease; however, bilaterally the external carotid artery was larger in size than the internal carotid artery, multiple prominent external carotid artery branches were noted, the internal carotid artery and vertebral artery Doppler signals demonstrated low-resistance waveforms with high diastolic flow velocity, and the left vertebral artery was enlarged. Magnetic resonance imaging with angiography demonstrated multiple intracranial abnormalities, and conventional angiography was compatible with Moyamoya disease. A superficial temporal artery-to-middle cerebral artery bypass was performed with an uneventful postoperative course and no recurrence of symptoms. Conclusions Subtle changes in anatomy and Doppler signals observed during an extracranial carotid duplex examination can be important indicators of pathology in a location that is not under direct visualization and interrogation. It is important for the sonographer to note these changes and report them to the physician for further evaluation by more direct methods of testing. This case provides an example of the use of such indirect sonographic evidence.

Spontaneous opening of large occipital-vertebral artery anastomosis during embolization

1980 ◽  
Vol 53 (6) ◽  
pp. 849-850 ◽  
Author(s):  
Robert F. Spetzler ◽  
Michael Modic ◽  
Charles Bonstelle
Keyword(s):  
Carotid Artery ◽  
Vertebral Artery ◽  
Therapeutic Embolization ◽  
External Carotid Artery ◽  
External Carotid ◽  
Occipital Artery ◽  
Dural Arteriovenous Malformation ◽  
Artery Embolization ◽  
Content Type ◽  
Fluoroscopic Control

✓ A patient undergoing external carotid artery therapeutic embolization for obliteration of a dural arteriovenous malformation suddenly developed a large occipital artery to vertebral artery shunt. A devastating stroke was averted because the appearance of the shunt was observed by fluoroscopy, the embolization was stopped, and the shunt verified on a subsequent angiogram. The risk of external carotid artery embolization without constant fluoroscopic control is emphasized.

scholarly journals Protection of Anastomotic Pathways to the Vertebral Artery During Stenting of External Carotid Artery Stenosis

2010 ◽  
Vol 50 (11) ◽  
pp. 1001-1005 ◽  
Author(s):  
Toru YAMAGATA ◽  
Yutaka MITSUHASHI ◽  
Akimasa NISHIO ◽  
Taichiro KAWAKAMI ◽  
Masaki YOSHIMURA ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Vertebral Artery ◽  
Carotid Artery Stenosis ◽  
External Carotid Artery ◽  
Artery Stenosis ◽  
External Carotid

scholarly journals A Five-Vessel Aortic Arch with an Anomalous Origin of Both Vertebral Arteries and an Aberrant Right Subclavian Artery

2004 ◽  
Vol 10 (4) ◽  
pp. 309-314 ◽  
Author(s):  
P.A. Brouwer ◽  
M.P.S. Souza ◽  
R. Agid ◽  
K.G. terBrugge
Keyword(s):  
Carotid Artery ◽  
Vertebral Artery ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Common Carotid Artery ◽  
Anomalous Origin ◽  
Aberrant Right Subclavian Artery ◽  
Left Vertebral Artery ◽  
Transverse Foramen ◽  
The Right

In this case presentation we describe a patient with an anomalous origin of the right vertebral artery arising from the right common carotid artery in combination with an aberrant right subclavian artery and a left vertebral artery originating from the arch between the left common carotid artery and left subclavian artery. Hence there were five vessels originating from the aortic arch. The possible embryological mechanism as well as a postulation on the importance of the level of entrance of the vertebral artery in the cervical transverse foramen is discussed.

Vertebral Artery Disease

Neurosurgery ◽  
1981 ◽  
Vol 9 (5) ◽  
pp. 524-530 ◽  
Author(s):  
Michael B. Pritz ◽  
William F. Chandler ◽  
Glenn W. Kindt
Keyword(s):  
Carotid Artery ◽  
Vertebral Artery ◽  
Medical Management ◽  
Posterior Inferior Cerebellar Artery ◽  
External Carotid Artery ◽  
The Other ◽  
External Carotid ◽  
Occipital Artery ◽  
Cerebellar Artery ◽  
Artery Disease

Abstract The neuroradiological evaluation, perioperative medical management, and microsurgical treatment of variously located vertebral artery lesions are presented. Four types of surgical procedures were undertaken: proximal vertebral artery to common carotid artery end-to-side anastomosis; external carotid artery to midcervical vertebral artery end-to-side anastomosis; external carotid artery to distal cervical vertebral artery end-to-end anastomosis; and occipital artery to posterior inferior cerebellar artery end-to-side anastomosis. Each case is used to demonstrate the evaluation and management involved, the type of and rationale for the surgical procedure selected, and the patency of the anastomosis performed. Two points are emphasized. One is that, after careful angiographic evaluation and improved perioperative medical management, lesions of the vertebral artery are indeed amenable to microsurgical intervention with relatively low risk to the patient. The other is that, whenever possible, anastomosis of the largest caliber of vessels with the least number of suture lines is the surgical treatment of choice.

Multimodality Treatment of a Complex Cervicocerebral Arteriovenous Shunt in a Patient With CHARGE Syndrome

Neurosurgery ◽  
2010 ◽  
Vol 67 (1) ◽  
pp. E208-E209 ◽  
Author(s):  
Shervin R. Dashti ◽  
Robert F. Spetzler ◽  
Min S. Park ◽  
Michael F. Stiefel ◽  
Humain Baharvahdat ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Vertebral Artery ◽  
Common Carotid Artery ◽  
Heart Defects ◽  
Charge Syndrome ◽  
Left Common Carotid Artery ◽  
Innominate Vein ◽  
Arteriovenous Shunt ◽  
Left Vertebral Artery ◽  
External Carotid

Abstract OBJECTIVE We present our management of a unique case of complex arteriovenous shunt with vascular steal in the left-sided head and neck vessels in a child with CHARGE (Coloboma of the eye, Heart defects, Atresia of the choanae, Retardation of growth and/or development, Genital and/or urinary abnormalities, and Ear abnormalities and deafness) syndrome. CLINICAL PRESENTATION A 10-year-old girl presented with high-output heart failure. Cerebral angiography revealed high-flow abnormal fistulous connections between the left common carotid artery and innominate vein as well as between the vertebral artery and innominate vein. There was significant collateral blood flow to the fistulae from the left external carotid artery and left thyrocervical and costocervical trunks. INTERVENTION The left vertebral artery-to-innominate vein fistula was occluded by endovascular means during temporary balloon occlusion. The left common carotid artery-to-innominate vein fistula was occluded through neck dissection with surgical clipping. CONCLUSION Combined neurosurgical and endovascular techniques were used successfully to manage a complex arteriovenous fistula in a patient with CHARGE syndrome. Challenges in therapeutic decision making are discussed.

Sign in / Sign up

Export Citation Format

Share Document