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 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.

scholarly journals Effect of Stellate Ganglion Block on the Cerebrovascular System

2010 ◽  
Vol 113 (4) ◽  
pp. 936-944 ◽  
Author(s):  
Chang-Ki Kang ◽  
Seung-Taek Oh ◽  
Rack Kyung Chung ◽  
Hyon Lee ◽  
Chan-A Park ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Carotid Artery ◽  
Signal Intensity ◽  
Ophthalmic Artery ◽  
Stellate Ganglion ◽  
Stellate Ganglion Block ◽  
External Carotid Artery ◽  
External Carotid ◽  
Ganglion Block

Background Several studies have shown that stellate ganglion block (SGB) is an effective treatment for certain cerebrovascular related diseases; however, the direct effect of SGB on the cerebral vasculature is still unknown. The present study investigated the effect of SGB on the cerebral vascular system using magnetic resonance angiography. Methods Time-of-flight magnetic resonance angiography images of 19 healthy female volunteers (mean ages of 46.4 ± 8.9 yr) were obtained before and after SGB with 1.5-T magnetic resonance imaging. The authors determined successful interruption of sympathetic innervation to the head with the appearance of Horner syndrome and conjunctival injection. We measured changes in the average signal intensity and diameter of the major intracranial and extracranial arteries and their branches, which were presented with mean (±SE). Results The signal intensity changes were observed mainly in the ipsilateral extracranial vessels; the external carotid artery (11.2%, P < 0.001) and its downstream branches, such as the occipital artery (9.5%, P < 0.001) and superficial temporal artery (14.1%, P < 0.001). In contrast, the intensities of the intracranial arteries did not change with the exception of the ipsilateral ophthalmic artery, which increased significantly (10.0%, P = 0.008). After SGB, only the diameter of the ipsilateral external carotid artery was significantly increased (26.5%, P < 0.001). Conclusions We were able to observe significant changes in the extracranial vessels, whereas the intracranial vessels were relatively unaffected (except for the ophthalmic artery), demonstrating that both perivascular nerve control and sympathetic nerve control mechanisms may contribute to the control of intracranial and extracranial blood vessels, respectively, after SGB.

Computed tomography and magnetic resonance angiography in the evaluation of aberrant origin of the external carotid artery branches

2012 ◽  
Vol 34 (5) ◽  
pp. 393-399 ◽  
Author(s):  
Salvatore Cappabianca ◽  
Assunta Scuotto ◽  
Francesco Iaselli ◽  
Nicoletta Pignatelli di Spinazzola ◽  
Fabrizio Urraro ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Carotid Artery ◽  
External Carotid Artery ◽  
External Carotid

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.

Magnetic resonance angiography evaluation of external carotid artery tributaries in moyamoya disease

2005 ◽  
Vol 64 (4) ◽  
pp. 325-330 ◽  
Author(s):  
Masaru Honda ◽  
Naoki Kitagawa ◽  
Keisuke Tsutsumi ◽  
Minoru Morikawa ◽  
Izumi Nagata ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Carotid Artery ◽  
Moyamoya Disease ◽  
External Carotid Artery ◽  
External Carotid

Bilateral Internal Carotid to Anterior Cerebral Artery Anastomosis with Anterior Communicating Artery Aneurysm: Technical Case Report

2005 ◽  
Vol 57 (suppl_4) ◽  
pp. ONS-E400-ONS-E400 ◽  
Author(s):  
Kaya Kılıç ◽  
Metin Orakdöğen ◽  
Aram Bakırcı ◽  
Zafer Berkman
Keyword(s):  
Case Report ◽  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cerebral Artery ◽  
Internal Carotid ◽  
Anterior Cerebral Artery ◽  
Artery Aneurysm ◽  
Anterior Communicating Artery

Abstract OBJECTIVE AND IMPORTANCE: The present case report is the first one to report a bilateral anastomotic artery between the internal carotid artery and the anterior communicating artery in the presence of a bilateral A1 segment, fenestrated anterior communicating artery (AComA), and associated aneurysm of the AComA, which was discovered by magnetic resonance angiography and treated surgically. CLINICAL PRESENTATION: A 38-year-old man who was previously in good health experienced a sudden onset of nuchal headache, vomiting, and confusion. Computed tomography revealed a subarachnoid hemorrhage. Magnetic resonance angiography and four-vessel angiography documented an aneurysm of the AComA and two anastomotic vessels of common origin with the ophthalmic artery, between the internal carotid artery and AComA. INTERVENTION: A fenestrated clip, introduced by a left pterional craniotomy, leaving in its loop the left A1 segment, sparing the perforating and hypothalamic arteries, excluded the aneurysm. CONCLUSION: The postoperative course was uneventful, with complete recovery. Follow-up angiograms documented the successful exclusion of the aneurysm. Defining this particular internal carotid-anterior cerebral artery anastomosis as an infraoptic anterior cerebral artery is not appropriate because there is already an A1 segment in its habitual localization. Therefore, it is also thought that, embryologically, this anomaly is not a misplaced A1 segment but the persistence of an embryological vessel such as the variation of the primitive prechiasmatic arterial anastomosis. The favorable outcome for our patient suggests that surgical treatment may be appropriate for many patients with this anomaly because it provides a complete and definitive occlusion of the aneurysm.

scholarly journals Unilateral variations in the branching pattern of right external carotid artery- a case report

2012 ◽  
Vol 01 (03) ◽  
pp. 136-140
Author(s):  
P Savithri
Keyword(s):  
Case Report ◽  
Carotid Artery ◽  
Lymph Nodes ◽  
Histopathological Examination ◽  
External Carotid Artery ◽  
Facial Artery ◽  
External Carotid ◽  
Lingual Artery ◽  
Branching Pattern ◽  
Muscular Artery

AbstractA case report of anomalous origin and branching pattern of right external carotid artery found during the dissection of human cadavers is reported here. Knowledge of anatomical variations of external carotid artery is especially important in head & neck surgeries. This knowledge is also important for radiologists in the image interpretation. In the case reported here, the right external carotid artery gave direct origin of one of dorsal lingual artery, two stylomastoid arteries, muscular artery and lymph nodal artery along with its normal eight branches. Generally the dorsal lingual arteries are two arising from lingual artery. Contrary to that, in this case the dorsal lingual arteries were found arising one from front of external carotid artery and other from lingual artery, and both these arteries communicated at 4mm beyond their origin. The two stylomastoid arteries arising directly from the front of external carotid artery 4mm above the facial artery were found arising with a gap of 2mm distance from one another. Muscular artery arose directly from the posterior aspect of external carotid artery opposite the anomalous dorsal lingual artery and descended downwards and forwards in its course giving small twigs to surrounding muscles . Lymph nodal artery arising just beside the muscular artery opposite to facial artery passed downwards and laterally and divided into two small twigs to supply a pair of lymph nodes. These lymph nodes are deep cervical nodes measuring about 5x5 mm in size hard in consistency on histopathological examination, found to be nonmalignant.

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