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European Spine Journal

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01-12-2016 | Original Article

Anatomical anomalies of the V3 segment of the vertebral artery in the Polish population

Authors: Jan Fortuniak, Ernest Bobeff, Michał Polguj, Katarzyna Kośla, Ludomir Stefańczyk, Dariusz J. Jaskólski

Published in: European Spine Journal | Issue 12/2016

Abstract

Purpose

The aim of this study is to evaluate the incidence of the anatomical anomalies of the V3 segment of the vertebral artery in the Polish population. There is conflicting evidence on the incidence of these anomalies: Asian-based studies show high incidence of 10 %, whereas the North American study identifies these anomalies in less than 1 % of patients.

Methods

1800 computed tomography angiographies (CTA) obtained at the Barlicki University Hospital in Lodz, Poland, were reviewed retrospectively.

Results

All the patients were Caucasians. There were 968 males and 832 females. The mean age of the patients was 58. CTAs were obtained for the following reasons: stroke 1312, trauma 25, vascular/aneurysm 216, and intracranial haemorrhage 247. Vertebral artery hypoplasia was present in 360 cases (20 %). Persistent intersegmental artery (type I anomaly) was not found in any study. Fenestration of the V3 vertebral artery (type II) was recognized in three angiograms (0.16 %). Vertebral artery ending up as posterior inferior cerebellar artery (type III anomaly) was seen in 11 patients (0.61 %).

Conclusions

Very low incidence of V3 segment anomalies does not justify in our opinion routine vascular imaging in patients undergoing posterior cervical instrumented procedures.

Baaj AA, Mummaneni PV, Uribe JS, Vaccaro AR, Greenberg MS (2012) Handbook of spine surgery. Thieme, New York, StuttgartCrossRef

Hong JT, Lee SW, Son BC et al (2008) Analysis of anatomical variations of bone and vascular structures around the posterior atlantal arch using three-dimensional computed tomography angiography. J Neurosurg Spine 8(3):230–236CrossRefPubMed

Yamazaki M, Okawa A, Furuya T et al (2012) Anomalous vertebral arteries in the extra- and intraosseous regions of the craniovertebral junction visualized by 3-dimensional computed tomographic angiography: analysis of 100 consecutive surgical cases and review of the literature. Spine 37(22):1389–1397CrossRef

O’Donnell CM, Child ZA, Nguyen Q et al (2014) Vertebral artery anomalies at the craniovertebral junction in the US population. Spine 39(18):1053–1057CrossRef

Sanders WP, Sorek PA, Mehta BA (1993) Fenestration of intracranial arteries with special attention to associated aneurysms and other anomalies. Am J Neuroradiol 14:675–680PubMed

Kadyi H (1888) Uber die Blutgefässe des Menschlichen Ruckenmarkes. Verlag von Gubrynowicz & Schmidt, Lwow

Lasjaunias P, Braun JP, Hasso AN, Moret J, Manelfe C (1980) True and false fenestration of the vertebral artery. J Neuroradiol 7:157–166PubMed

Lasjaunias P (1983) Craniofacial and upper cervical arteries: collateral circulations and angiographic protocols. Williams and Wilkins, Baltimore

Yamazaki M, Okawa A, Hashimoto M et al (2008) Abnormal course of the vertebral artery at the cranio-vertebral junction in patients with Down syndrome visualized by three-dimensional CT angiography. Neuroradiology 50:485–490CrossRefPubMed

10.

Yamazaki M, Koda M, Yoneda M et al (2004) Anomalous vertebral artery at the craniovertebral junction in a patient with Down syndrome. Case report. J Neurosurg Spine 1(3):338–341CrossRefPubMed

11.

Ciołkowski MK, Krajewski P, Ciszek B (2014) A case of vertebral artery duplication at the level of atlas: anatomical description. Eur Spine J 23(Suppl 2):285–287CrossRefPubMed

12.

Fujimura M, Sugawara T, Higuchi H et al (1997) A ruptured aneurysm at the distal end of the basilar artery fenestration associated with multiple fenestrations of the vertebrobasilar system: case report. Surg Neurol 47(5):469–472CrossRefPubMed

13.

Thierfelder KM, Baumann AB, Sommer WH et al (2014) Vertebral artery hypoplasia: frequency and effect on cerebellar blood flow characteristics. Stroke 45(5):1363–1368CrossRefPubMed

14.

Kara SA, Erdemoglu AK, Karadeniz MY et al (2003) Color Doppler sonography of orbital and vertebral arteries in migraineurs without aura. J Clin Ultrasound 31:308–314CrossRefPubMed

15.

Lovrencic-Huzjan A, Demarin V, Rundek T et al (1998) Role of vertebral artery hypoplasia in migraine. Cephalalgia 18:684–686CrossRefPubMed

16.

Ratanakorn D, Yunis C, Ferrario CM et al (2002) Noninvasive ultrasound evaluation of the vertebral artery in hypertension. J Neuroimaging 12:158–163CrossRefPubMed

17.

Uchino A, Kato A, Abe M et al (2001) Association of cerebral arteriovenous malformation with cerebral arterial fenestration. Eur Radiol 11(3):493–496CrossRefPubMed

18.

Finlay HM, Canham PB (1994) The layered fabric of cerebral artery fenestrations. Stroke 25(9):1799–1806CrossRefPubMed

19.

Wijdicks E, Sheth K, Carter B et al (2014) Recommendations for the management of cerebral and cerebellar infarction with swelling. a statement for health care professionals from the American Heart Association/American Stroke Association. Stroke 45:1222–1238CrossRefPubMed

Title: Anatomical anomalies of the V3 segment of the vertebral artery in the Polish population
Authors: Jan Fortuniak
Ernest Bobeff
Michał Polguj
Katarzyna Kośla
Ludomir Stefańczyk
Dariusz J. Jaskólski
Publication date: 01-12-2016
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 12/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-016-4675-1

At a glance: The STEP trials

Springer Medicine

Anatomical anomalies of the V3 segment of the vertebral artery in the Polish population

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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