Sato H, Ogawa A, Kitahara M, Kayama T, Sakurai Y, Suzuki J
Stroke Center, Sendai National Hospital, Japan.
No To Shinkei. 1988 Mar;40(3):219-24.
A rare case of persistent primitive first cervical intersegmental artery (proatlantal artery II) is reported. A 58-year-old man was admitted to our hospital with dysarthria and left hemiparesis. On admission he was stuporous with bilateral gaze palsy and left hemiparesis. CT scan on admission showed low density areas in the right cerebellar hemisphere and ventricular part of the pons. Right retrograde brachiography revealed occlusion of the basilar artery, aplasia of the right vertebral artery and an abnormal vessel connecting the right external carotid artery and the right vertebral artery. This anastomotic vessel was thought to be a persistent primitive first cervical intersegmental artery (Proatlantal artery II). Left carotid angiography revealed the left posterior cerebral artery was visualized through the posterior communicating artery, leading from the internal carotid artery. Left retrograde brachial angiography showed that the left vertebral artery terminated just distal from the branching of the left posterior inferior cerebellar artery. After admission the left hemiparesis deteriorated gradually and tracheotomy was done due to respiratory difficulties. The patient was then transferred to the rehabilitation center on his 34th day in hospital with neurological deficits.
报告了一例罕见的持续性原始第一颈段节间动脉（寰椎前动脉II型）病例。一名58岁男性因构音障碍和左侧偏瘫入院。入院时，他昏迷，伴有双侧凝视麻痹和左侧偏瘫。入院时的CT扫描显示右侧小脑半球和脑桥脑室部分有低密度区。右侧逆行肱动脉造影显示基底动脉闭塞、右侧椎动脉发育不全以及一条连接右侧颈外动脉和右侧椎动脉的异常血管。这条吻合血管被认为是持续性原始第一颈段节间动脉（寰椎前动脉II型）。左侧颈动脉造影显示左侧大脑后动脉通过后交通动脉显影，该后交通动脉起自颈内动脉。左侧逆行肱动脉造影显示左侧椎动脉在左小脑后下动脉分支的远侧端终止。入院后，左侧偏瘫逐渐加重，因呼吸困难行气管切开术。患者于住院第34天因神经功能缺损被转至康复中心。
