scholarly journals Morphometric Analysis of V2 Segment of Vertebral Artery in Patients with Symptomatic Neck Pain in South Indian Population – A CT Angiography Based Study

2021 ◽  
pp. 928-932
Author(s):  
S. G. Mathupriya ◽  
P. S. Arun Vignesh ◽  
S. Vishnu Raj ◽  
Abhinav Gandra ◽  
Nitesh Kumar Rathi
Keyword(s):  
Neck Pain ◽  
Vertebral Artery ◽  
Anterior Margin ◽  
Cervical Vertebra ◽  
Transverse Process ◽  
Horizontal Distance ◽  
Transverse Foramen ◽  
Medial Margin ◽  
Longus Colli ◽  
Anterior Tubercle

Objectives: The morphometric changes in the vertebral artery are essential for various interventions. Inadequate details about it can lead to risk of vertebral artery injury and other complications. This study explains the normal anatomical course of V2 segment of vertebral artery which is more prone for iatrogenic injury. Materials and Method: 25 adult patients with symptomatic neck pain were involved in the study. Various measurements were made from seventh cervical vertebra (C7) to the third cervical vertebra (C3) that included Distance from midline to VA, Distance from medial margin of Longus Colli to VA, Perpendicular distance from anterior margin of transverse process to center of VA, Horizontal distance from anterior tubercle to VA, sagittal and coronal diameter of the transverse foramen and vertebral artery. Result: Distance from midline, Distance from medial margin of Longus Colli, Perpendicular distance from anterior margin of transverse process to center of VA and Horizontal distance from anterior tubercle were increased towards right compared to left side. The sagittal and coronal diameter of the transverse foramen and vertebral artery decreased from C6 to C3 vertebra. Vertebral artery dominance was seen on left side in all cases. Conclusion: Preoperative assessment by computed tomography angiography helps to know the course of the vertebral artery, understand its patterns and assess various abnormalities thereby aids in preventing complications in future surgeries.

scholarly journals ANOMALOUS ORIGIN OF THE LEFT VERTEBRAL ARTERY. Origen anómalo de la arteria vertebral izquierda

2016 ◽  
Vol 5 (1) ◽  
pp. 33-38
Author(s):  
Divya Premchandran ◽  
Sampath Madhyastha
Keyword(s):  
Vertebral Artery ◽  
Present Report ◽  
Cervical Vertebra ◽  
Neck Region ◽  
Transverse Process ◽  
Sympathetic Trunk ◽  
Anomalous Origin ◽  
Left Vertebral Artery ◽  
Transverse Foramen ◽  
Common Carotid Arteries

Las variaciones de los principales vasos arteriales son de importancia clínica. La arteria vertebral (VA) normalmente surge de la arteria subclavia. El presente informe describe un origen anómalo de la arteria vertebral izquierda (LVA) desde el arco aórtico entre el origen de la subclavia izquierda y la arteria carótida común izquierda. Esta arteria cruzó superficialmente de medial a lateral el tronco simpático izquierdo. La VA izquierda y derecha entraban en los agujeros transversos de la quinta vértebra cervical. Aunque el origen anómalo de la VA es bien conocida, su origen y la entrada a través del foramen transversal y sus relaciones con tronco simpático son de importancia clínica y durante los procedimientos vasculares en la región de cabeza y cuello tales como los stent de arteria carótida o vertebral y las intervenciones intracraneales. Variations of major arterial vessels are of clinical significance. The vertebral artery (VA) normally arises from the subclavian artery. The present report describes an anomalous origin of the left vertebral artery (LVA) from the aortic arch between the origin of the left subclavian and the left common carotid arteries. This artery was crossed superficially from medial to lateral by the left sympathetic trunk. The left and right VA entered the foramen on the transverse process of the fifth cervical vertebra. Though the anomalous origin of the VA is known, its origin and entry through the transverse foramen and its relations with sympathetic trunk are of importance during clinical and vascular procedures in the head and neck region like carotid artery stents, VA stents and intracranial interventions.

Gross morphological and biometrical Studies on the typical cervical vertebrae of Blue bull (Boselaphus tragocamelus)

2018 ◽  
Author(s):  
S. Sathapathy ◽  
B.S. Dhote ◽  
I. Singh ◽  
D. Mahanta ◽  
S. Tamilselvan ◽  
...  
Keyword(s):  
Vertebral Body ◽  
Cervical Vertebrae ◽  
Cervical Vertebra ◽  
Transverse Process ◽  
Transverse Foramen ◽  
The Third

The present study was carried out on the third (C3), fourth (C4) and fifth (C5) cervical vertebrae of six specimens of adult Blue bull (Boselaphus tragocamelus) of either sex. It was found that the transverse process was bifid with a transverse foramen located at its base. The upper part of the transverse process projected backward and was short and stout, while the lower part was directed downward and forward and was found to be longer and more plate-like. The bodies of C3-C5 tended to become shorter and wider from front to backwards. The supraspinous process was found to be short and centrally tuberous in C3 that gradually increased in height and length to C5 with forward inclination. The articular processes of the typical cervical vertebrae slightly convex cranially and concave caudally. The posterior articular facets of C5 were egg shaped, whereas those of C4 were like the map of Africa in the Blue bull. A well defined infraspinous process projected from the vertebral body that divided the base into two halves. The biometrical observations on different parameters of typical cervical vertebra reflected significance (P less than 0.05) differences between the sexes of this species.

scholarly journals Dimensions and Anatomical Variants of the Foramen Transversarium of Typical Cervical Vertebrae

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Santosh Kaur Sangari ◽  
Paul-Michel Dossous ◽  
Thomas Heineman ◽  
Estomih Phillip Mtui
Keyword(s):  
Vertebral Artery ◽  
Thrombus Formation ◽  
Cervical Vertebrae ◽  
Uncinate Process ◽  
Vertebrobasilar Insufficiency ◽  
Transverse Foramen ◽  
Medial Margin ◽  
Significant Difference ◽  
The Mean ◽  
The Right

The study was conducted on random sample of seventy-one dried, typical cervical vertebrae (C3–C6). The data on the age, sex, and built was not available. Using vernier calipers with 0.01 mm accuracy, the anteroposterior and transverse diameters of transverse foramina and their distance from the medial margin of the uncinate process were measured bilaterally. The mean diameter of the right/left transverse foramen varied from 2.54 mm to 7.79 mm (mean = 5.55 ± 0.87 mm) and from 2.65 mm to 7.35 mm (mean = 5.48 ± 0.77 mm), respectively. The transverse foramen was less than 3.5 mm in three vertebrae on the right and two on the left. The osteocytes observed in 21.3% of specimens and the narrow transverse foramen may place patients at risk for vertebrobasilar insufficiency or thrombus formation. The mean distance of the transverse foramen from the medial margin of uncinate process is an important landmark to avoid vertebral artery laceration and was 5.0 ± 0.87 mm (range: 3.5–7.9 mm) on the right and 5.0 ± 1.0 mm (range: 3.2–7.7 mm) on the left side. No statistically significant difference was observed between the right and left sides. The accessory transverse foramina seen in 24% of vertebrae suggest duplications or fenestrations in the vertebral artery.

Antero-Lateral Approach To The V3 Segment Of The Vertebral Artery

2006 ◽  
Vol 58 (suppl_1) ◽  
pp. ONS-29-ONS-35 ◽  
Author(s):  
Michaël Bruneau ◽  
Jan Frederick Cornelius ◽  
Bernard George
Keyword(s):  
Surgical Technique ◽  
Vertebral Artery ◽  
Dura Mater ◽  
Transverse Process ◽  
Foramen Magnum ◽  
Lateral Approach ◽  
Occipital Condyle ◽  
Exposure Control ◽  
Transverse Foramen ◽  
Inferior Aspect

Abstract OBJECTIVE: We describe our surgical technique of exposure, control, and transposition of the third segment of the vertebral artery (VA V3 segment). METHODS: The VA V3 segment extends from the C2 transverse foramen to the dura mater of the foramen magnum. It initially courses vertically between the C2 and C1 transverse foramens, then runs horizontally over the atlas groove, and finally obliquely upwards before piercing the dura mater. Exposure of the VA V3 segment through an antero-lateral approach is performed by passing medially to the ster-nomastoid muscle. After exposure and protection of the spinal accessory nerve, the C1 transverse process is identified below and in front of the mastoid tip. The small muscles that insert on it are cut to expose the C1-C2 portion. The inferior aspect of the horizontal portion is safely separated from the atlas groove by elevating the subperiosteal plane and the superior aspect is freed by a cut a few millimeters above the VA on the occipital condyle. Complete unroofing of the C1 transverse foramen is achieved by resecting the bone while leaving intact the subperiosteal plane. The VA then can be transposed. Venous bleedings during the dissection from periosteal sheath tearing can be controlled by direct bipolar coagulation. RESULTS: The control of the VA V3 segment is essentially used for lesions in the VA vicinity and to improve the surgical exposure at the craniocervical junction level. Indications therefore are tumoral removal, VA decompression, and rarely, nowadays, VA revascularization. CONCLUSION: Perfect knowledge of the anatomy and the surgical technique permits a safe exposure, control, and transposition of the VA V3 segment. This is the first step of many surgical procedures.

scholarly journals Carotid ultrasound features of anomalous left vertebral artery originating from the aortic arch proximal to the left subclavian artery

2017 ◽  
Vol 30 (2) ◽  
pp. 168-171
Author(s):  
Masayuki Wakita ◽  
Ran Takei ◽  
Fumio Miyashita ◽  
Yuki Hamada ◽  
Satoshi Ohyama ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Vertebral Artery ◽  
Left Subclavian Artery ◽  
Three Dimensional ◽  
Cervical Vertebra ◽  
Duplex Ultrasound ◽  
Left Vertebral Artery ◽  
Carotid Ultrasound ◽  
Transverse Foramen ◽  
Ultrasound Features

We present three cases of anomalous origin of the left vertebral artery (LVA) detected during the evaluation of stroke. The VA usually enters the transverse foramen of the sixth cervical vertebra (C6), but an anomalous LVA originating from the aorta frequently enters at a higher level. In our series, ultrasound of the LVA showed entry at C4 in two patients and at C5 in one patient. These findings suggested anomalous LVA origin, and three-dimensional computed tomography demonstrated the LVA arising from the aorta proximal to the left subclavian arteries. Carotid duplex ultrasound is useful for the diagnosis of this anomaly.

Management of the Vertebral Artery at the Craniocervical Junction

2005 ◽  
Vol 133 (1) ◽  
pp. 84-88 ◽  
Author(s):  
YasLar Çokkeser ◽  
Maged B. Naguib ◽  
Ahmet Kizilay
Keyword(s):  
Vertebral Artery ◽  
Skull Base ◽  
Cervical Vertebra ◽  
Craniocervical Junction ◽  
Lateral Approach ◽  
Surgical Anatomy ◽  
Transverse Foramen ◽  
Close Vicinity ◽  
Vertebrobasilar Junction

OBJECTIVES: To study the surgical anatomy of the vertebral artery at the craniocervical junction and its related structures defining reliable landmarks for its safe exposure. DESIGN: Ten sides of 5 fresh cadavers were dissected using the lateral approach to the craniocervical junction. RESULTS: Experience gained in studying the anatomic details of the vertebral artery at the craniocervical junction in cadavers from its exit at the transverse foramen of the second cervical vertebra to the vertebrobasilar junction provided the initial background for us to use the lateral approaches to the skull base to safely manage 4 cases with pathology reaching the close vicinity of vertebral artery at the craniocervical junction. CONCLUSION: Thorough knowledge of the anatomy of the vertebral artery is mandatory before attempting surgery at the craniocervical junction. There are reliable landmarks that, when followed, could facilitate safe exposure and identification of the artery.

Cervical Vertebral Artery Rerouting: A Technique for Releasing Kinks and Restoring Endovascular Access

2010 ◽  
Vol 66 (suppl_1) ◽  
pp. ons-134-ons-137
Author(s):  
Michaël Bruneau ◽  
Boris Lubicz ◽  
Benoit J Pirotte ◽  
Aloys DeWindt ◽  
Michal Rynkowski ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Vertebral Artery ◽  
Transverse Process ◽  
Mass Effect ◽  
Resonance Imaging ◽  
Nerve Roots ◽  
Transverse Foramen ◽  
Surrounding Soft Tissue ◽  
Supraclavicular Approach ◽  
V1 Segment

Abstract Background: The endovascular treatment of intracranial aneurysms can be hampered by the tortuosity of extracranial vessels. Percutaneous or surgical vessel puncture can resolve the problem of inaccessibility. Objective: We describe rerouting of a kinked vertebral artery (VA) to restore transfemoral endovascular access to an aneurysm. Case Report: A 63-year-old woman presented with progressive hemiparesis. Magnetic resonance imaging demonstrated a left fusiform vertebrobasilar aneurysm with mass effect on the brainstem. The patient was found to have a dominant left VA on angiography with a severe kink in its V1 segment. Tight loops of this segment prevented catheter progression past V1 during endovascular treatment. Intervention: The left VA was rerouted from its subclavian origin to the C5 transverse foramen through a combined lateral and supraclavicular approach. Release of the VA off the C6 transverse process and C6 and C7 cranial nerve roots permitted unfolding of the VA. The excess length of the VA, initially present between the subclavian artery and the C6 transverse process, was spread over a longer distance. The tight angles present preoperatively were converted into a harmonious curvature. The rerouted VA was attached to surrounding soft tissue to maintain its position. The patient’s postoperative course was uneventful. Endovascular treatment of the aneurysm was performed 15 days later. Conclusion: The VA rerouting technique can be used successfully in patients in whom tight loops in the VA prevent endovascular access to intracranial vessels.

scholarly journals STUDY OF ACCESSORY FORAMEN TRANSVERSARIA IN CERVICAL VERTEBRAE

2013 ◽  
Vol 03 (04) ◽  
pp. 097-099 ◽  
Author(s):  
Pretty Rathnakar ◽  
Remya K. ◽  
Keyword(s):  
Vertebral Artery ◽  
Cervical Vertebrae ◽  
Cervical Vertebra ◽  
Transverse Process ◽  
Vertebral Arteries ◽  
Seventh Cervical Vertebra ◽  
Accessory Foramen

AbstractThe cervical vertebrae presents foramen transversaria in each transverse process. In all but the seventh cervical vertebra, the foramen normally transmits vertebral artery and vein and a branch from the cervicothoracic ganglion.140 cervical vertebrae were studied. Variations were noticed in the number of foramen transversarium unilaterally and bilaterally. Variations in foramen transversarium may indicate the variation in course of vertebral arteries

scholarly journals Functional cervicothoracic boundary modified by anatomical shifts in the neck of giraffes

2016 ◽  
Vol 3 (2) ◽  
pp. 150604 ◽  
Author(s):  
Megu Gunji ◽  
Hideki Endo
Keyword(s):  
Cervical Vertebrae ◽  
Cervical Vertebra ◽  
Thoracic Vertebra ◽  
Large Displacement ◽  
Thoracic Vertebrae ◽  
The Novel ◽  
Neck Movement ◽  
Similar Shape ◽  
Seventh Cervical Vertebra ◽  
Longus Colli

Here we examined the kinematic function of the morpho- logically unique first thoracic vertebra in giraffes. The first thoracic vertebra of the giraffe displayed similar shape to the seventh cervical vertebra in general ruminants. The flexion experiment using giraffe carcasses demonstrated that the first thoracic vertebra exhibited a higher dorsoventral mobility than other thoracic vertebrae. Despite the presence of costovertebral joints, restriction in the intervertebral movement imposed by ribs is minimized around the first thoracic vertebra by subtle changes of the articular system between the vertebra and ribs. The attachment area of musculus longus colli , mainly responsible for ventral flexion of the neck, is partly shifted posteriorly in the giraffe so that the force generated by muscles is exerted on the cervical vertebrae and on the first thoracic vertebra. These anatomical modifications allow the first thoracic vertebra to adopt the kinematic function of a cervical vertebra in giraffes. The novel movable articulation in the thorax functions as a fulcrum of neck movement and results in a large displacement of reachable space in the cranial end of the neck. The unique first thoracic vertebra in giraffes provides higher flexibility to the neck and may provide advantages for high browsing and/or male competition behaviours specific to giraffes.

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