Öner Zülal, Öner Serkan, Kahraman Ayşegül Sağır
Department of Anatomy, Karabük University Faculty of Medicine, Karabük, Turkey.
Department of Radiology, Karabük University Faculty of Medicine, Karabük, Turkey.
Surg Radiol Anat. 2017 Dec;39(12):1397-1400. doi: 10.1007/s00276-017-1882-3. Epub 2017 Jun 5.
Variations in the origin of the vertebral artery (VA) is a congenital anomaly that occurs during embryological development. Multiple variations related to VA origin have been reported in the literature. Abnormal VA origin is usually determined as incidental findings during angiographic or postmortem anatomical studies. Although most of the cases are asymptomatic, in patients with VA anomaly symptoms such as dizziness have been described. The anomalous variation in the origin of the right VA is rare and separated into three categories: (1) originating from the aorta, (2) originating from the carotid arteries, (3) duplicated origin. In this case, we aimed to present the right VA originating from the right occipital artery and concomitant anomalies of the transverse foramen that have not been reported previously according to our knowledge in literature. In a 32-year-old female patient referred to our hospital because of dizziness, the right VA was not observed on magnetic resonance imaging and computed tomography angiography (CTA) examination was performed. CTA showed hypoplasia of the right transverse foramen at the levels of the C1, C5 and C6 vertebrae and aplasia of the right transverse foramen at the levels of the C2, C3 and C4 vertebrae. The right VA originating from the right occipital artery continues to its normal course by entering the cranium through the foramen magnum at the level of the atlantooccipital junction.
椎动脉(VA)起源的变异是一种在胚胎发育过程中出现的先天性异常。文献中已报道了多种与VA起源相关的变异。异常的VA起源通常在血管造影或尸检解剖研究中作为偶然发现被确定。尽管大多数病例无症状,但也有患者出现过如头晕等VA异常症状的描述。右VA起源的异常变异较为罕见,可分为三类:(1)起源于主动脉,(2)起源于颈动脉,(3)重复起源。在本病例中,我们旨在呈现起源于右枕动脉的右VA以及据我们所知在文献中未曾报道过的横突孔伴随异常。在一名因头晕前来我院就诊的32岁女性患者中,磁共振成像未观察到右VA,遂进行了计算机断层血管造影(CTA)检查。CTA显示,在C1、C5和C6椎体水平右侧横突孔发育不全,在C2、C3和C4椎体水平右侧横突孔缺如。起源于右枕动脉的右VA在寰枕关节水平通过枕骨大孔进入颅骨后继续走行至正常路径。