Singh Rajani
Department of Anatomy, AIIMS Rishikesh, Rishikesh, India.
J Craniofac Surg. 2017 Jun;28(4):1105-1106. doi: 10.1097/SCS.0000000000003515.
Though the variations of vertebral artery are clinically asymptomatic yet abnormalities are of diagnostic importance either prior to vascular surgery in the neck region or in patients of intravascular diseases such as arteriovenous malformations or cerebral aneurysms. Therefore, the aim of the study is to bring out 2 variations in the configuration of vertebral artery and their clinical implication. During dissection of thorax of 2 female cadavers, 2 different variants of configurations of left vertebral arteries were observed. In 1 patient, the left vertebral artery arose aberrantly from arch of aorta between left common carotid artery and left subclavian artery. This artery then, following oblique course, abnormally entered into foramen transversarium of C4 vertebra. In the second patient, the left common stump emerged from arch of aorta in the left side of left common carotid artery and then instantly bifurcated into vertebral artery and subclavian artery. Then following the usual oblique course, the left vertebral artery anomalously entered into foramen transversarium of C3 vertebra at the level of upper border of thyroid cartilage. The knowledge of these rare variations in the origin of vertebral artery is of paramount importance to surgeons performing surgery in neck region, radiologist performing angiography to avoid misinterpretation of radiographs and to anatomists for rare variations in academics and research.
尽管椎动脉的变异在临床上通常无症状,但这些异常在颈部血管手术前或患有诸如动静脉畸形或脑动脉瘤等血管疾病的患者中具有重要的诊断意义。因此,本研究的目的是揭示椎动脉形态的两种变异及其临床意义。在解剖两具女性尸体的胸部时,观察到左椎动脉形态的两种不同变异。在1例患者中,左椎动脉异常发自主动脉弓,位于左颈总动脉和左锁骨下动脉之间。然后,该动脉沿斜行路径,异常进入第4颈椎的横突孔。在第二例患者中,左总干从主动脉弓左侧的左颈总动脉处发出,然后立即分为椎动脉和锁骨下动脉。接着,左椎动脉沿通常的斜行路径,在甲状软骨上缘水平异常进入第3颈椎的横突孔。了解椎动脉起源的这些罕见变异,对于在颈部进行手术的外科医生、进行血管造影以避免对X光片误判的放射科医生以及在学术和研究中关注罕见变异的解剖学家来说至关重要。