Presence of a foramen arcuale as a possible cause for headaches and migraine: Systematic review and meta-analysis

Pękala, Przemysław A.; Henry, Brandon Michael; Phan, Kevin; Pękala, Jakub R.; Taterra, Dominik; Walocha, Jerzy; Tubbs, R. Shane; Tomaszewski, Krzysztof A.

doi:10.1016/j.jocn.2018.05.008

Cited by 15 publications

(16 citation statements)

References 16 publications

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“…2017; Pękala et al . 2018), but more importantly, the vertebral artery may be compressed when the complete AF is present (Pękala et al . 2017), and the presence of an AF has been associated with clinical symptoms such as migraine, cervicogenic headache, vertigo, nausea, retro‐orbital pain, acute headache, neck pain, arm pain, shoulder pain, dissection of the vertebral artery, and so on (Wight et al .…”

Section: Discussionmentioning

confidence: 99%

“…2017; Pękala et al . 2018). It is of special importance because the presence of the AF in Neanderthals may have had a clinical implication as it currently does in the case of H. sapiens .…”

Section: Discussionmentioning

confidence: 99%

“…2017; Pękala et al . 2018; Sanchis‐Gimeno et al 2018a; 2018b), little has been published about the presence of anatomical variants of the atlas in a Neanderthal population. Nevertheless, and in spite of the low number of Neanderthal atlases recovered to date, the presence of anatomical variations, such as non‐fused arches, has been described in the El Sidrón (Asturias, Northern Spain) Neanderthal group (Ríos et al .…”

Section: Introductionmentioning

confidence: 99%

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Krapina atlases suggest a high prevalence of anatomical variations in the first cervical vertebra of Neanderthals

et al. 2020

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The first cervical vertebra, atlas, and its anatomical variants have been widely studied in Homo sapiens. However, in Neanderthals, the presence of anatomical variants of the atlas has been very little studied until very recently. Only the Neanderthal group from the El Sidrón site (Spain) has been analysed with regard to the anatomical variants of the atlas. A high prevalence of anatomical variants has been described in this sample, which points to low genetic diversity in this Neanderthal group. Even so, the high prevalence of anatomical variations detected in El Sidrón Neanderthal atlases needs to be confirmed by analysing more Neanderthal remains. In this context, we analysed the possible presence of anatomical variants in the three Neanderthal atlases recovered from the Krapina site (Croatia) within the Neanderthal lineage. Two of the three Krapina atlases presented anatomical variations. One atlas (Krapina 98) had an unclosed transverse foramen and the other (Krapina 99) presented a non‐fused anterior atlas arch. Moreover, an extended review of the bibliography also showed these anatomical variations in other Middle and Upper Pleistocene hominins, leading us to hypothesise that anatomical variations of the atlas had a higher prevalence in extinct hominins than in modern humans.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Krapina atlases suggest a high prevalence of anatomical variations in the first cervical vertebra of Neanderthals

et al. 2020

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“…The bony bridging of the vertebral artery in the sulcus arteriae vertebralis is a common osseous anomaly, the prevalence of which is given as 9.1% in a meta‐analysis by Pekala et al, (2017). The amount of studies carried out and the literature written on this subject is immense, so that we only refer to some fundamental works at this point (Hauser & de Stefano, 1989; Hayek, 1927; Kimmerle, 1930; Pekala et al, 2017, 2018; Prescher, 1997; Torklus & Gehle, 1975). Due to its topographic relation to the vertebral artery (Figure 6), especially the Ponticulus atlantis posterior (but also other Proatlas‐manifestations) have been identified as a risk factor for the development for manifold disorders: headache, migraine cervicale, neck pain, shoulder pain, dissection of vertebral artery and other, mostly neurological, symptoms.…”

Section: Discussionmentioning

confidence: 99%

The Ligamentum condylicum posterius as a precursor structure of the Processus condylicus posterior, another Proatlas‐Manifestation of the human occipital bone

Wolf-Vollenbröker

Prescher

2021

Journal of Anatomy

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This article presents the results of a dissection series investigating a previously neglected ligamentous structure attached to the human occipital bone, the Ligamentum condylicum posterius or posterior condylar ligament, and relates these results to the manifestation of a likewise poorly recognized occipital bony variation, the Processus condylicus posterior. The dissection of 50 human cranio‐cervical junctions revealed the existence of the posterior condylar ligament in 98% of all cases, sometimes containing free elongated ossicles and osseous spurs at the insertion points at the occipital bone. In two cases the osseous formation of a Processus condylicus posterior became apparent (4%), which further provided the opportunity to study the behaviour of the ligament in these cases. In this article, we show and discuss that the posterior condylar ligament and osseous structures possibly derive from tissue that originates from the material of the dorsal arch of the Proatlas, a rudimentary vertebra between occipital bone and atlas. For this purpose, the Ponticulus atlantis posterior as another Proatlas‐manifestation, whose origin from the dorsal Proatlas‐arch is widely accepted in literature, is considered. This bony variant was found in 11 specimens (22%) in the present study and further served to classify and interpret the findings of the much rarer Processus condylicus posterior. As a result of this dissection series and a review of literature on this understudied topic, a typology of manifestations of the posterior condylar ligament, Processus condylicus posterior and related structures like free ossicles has been introduced.

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“…It has been reported that the only advantage of this variation is the low risk of fracture, and it has also been reported that it usually leads to dissection by stretching the VA, vertebrobasilar ischemia during strong interventions in the cervical spine, complications in cases where C1-C2 stabilization is required, and Barre Lieou syndrome mostly by causing neurovascular compression (1,5,7,14,15,18,19,(22)(23)(24)(25)(26)(27).…”

Section: Discussionmentioning

confidence: 99%

The Importance of Arcuate Foramen, A Variation of the Atlas: A Microsurgical Cadaveric Study and Review of the Literature

Keser¹,

Çıkla²,

Özaydın³

et al. 2019

Istanbul Med J

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Amaç: Arkuat foramen (AF) atlasın posterior arkındaki vertebral arter (VA) oluğunda (sulkus arteriae vertebralis) bulunan, prevalansı bölgesel ve etnik faktörler nedeni ile değişebilen osseöz bir varyasyondur. AF'nin içindeki yapılara bası oluşturarak vertebrobaziler yetmezlik bulgularına neden olduğu düşünülse de bu kliniği açıklayacak yeterli sayıda kadavra çalışması yoktur. Yöntemler: AF varyasyonun insidansını ve içinden geçen VA ile olan ilişkisini değerlendirmek için renkli silikon enjekte edilmiş ve rastgele olarak seçilmiş 10 kadavranın 20 tarafı Wisconsin Üniversitesi Nöroanatomi Laboratuvarı'nda mikroşirürjikal yöntem ile incelendi. Bulgular: Örneklerin %30'unda atlasta komplet tipte AF varyasyonu saptandı. Bu varyasyon iki olguda sağda tek taraflı iken bir olguda bilateraldi. AF'nin ortalama boyutları sağda D1=6 mm, D2=5,5 mm, solda D1=7,5 mm, D2=6,5 mm, VA'nın ortalama çapı ise foramen öncesi, foramen içi ve foramen sonrası sırası ile sağda 4 mm, 2,5 mm ve 3 mm, solda 6 mm, 4 mm ve 5 mm idi. Olguların hepsinde suboksipital sinir AF içerisinde VA'ya eşlik ediyordu. Sonuç: Bu varyasyonun yüksek insidansının olabileceğinin bilinmesi kraniyoservikal bileşke ameliyatlarından önce ameliyat stratejisinin belirlenmesini ve hayati tehlike yaratabilecek arter yaralanmalarının engellenmesini sağlayabilir. Ayrıca, AF boyutlarının VA'nın rahatlıkla geçişine uygun olmasına karşın foramen içinden geçen diğer yapılar nedeni ile arteryel bası oluşturduğunun görülmesi foramen dekompresyonu ile olguların çoğunun rahatlama nedenini de açıklayabilir. Anahtar Kelimeler: Arkuat foramen, atlas, kadavra çalışması, osseöz anomali, vertebral arter, vertebrobaziler yetmezlik Introduction: Arcuate foramen (AF) is an osseous variation located on the vertebral artery (VA) groove (sulcus arteriae vertebralis) at the posterior arch of the atlas. Its prevalence may vary due to regional and ethnic factors. Although it is thought that it causes compression of the structures inside AF and causes vertebrobasilar insufficiency, there are not enough cadaver studies to explain this clinical condition. Methods: To evaluate the incidence of AF variation and its relationship with VA, 20 sides of 10 randomly selected and silicone injected cadaveric heads were examined by microsurgical method at the University of Wisconsin Neuroanatomy Laboratory. Results: Complete AF variation in atlas was detected in 30% of the samples. This variation was unilateral on the right side in two cases and bilateral in one case. The mean dimensions of AF were D1=6 mm and D2=5.5 mm on the right, and D1=7.5 mm and D2=6.5 mm on the left. The mean pre-foraminal, foraminal and post-foraminal diameters of VA were 4 mm, 2.5 mm and 3 mm, respectively, on the right, and 6 mm, 4 mm and 5 mm, respectively, on the left. In all cases, the suboccipital nerve was accompanying VA in the AF. Conclusion: Being aware that this variation may have a high incidence may help to determine surgical strategy before craniocervical junction surgery and prevent life-threatening arterial injuries...

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Presence of a foramen arcuale as a possible cause for headaches and migraine: Systematic review and meta-analysis

Cited by 15 publications

References 16 publications

Krapina atlases suggest a high prevalence of anatomical variations in the first cervical vertebra of Neanderthals

Krapina atlases suggest a high prevalence of anatomical variations in the first cervical vertebra of Neanderthals

The Ligamentum condylicum posterius as a precursor structure of the Processus condylicus posterior, another Proatlas‐Manifestation of the human occipital bone

The Importance of Arcuate Foramen, A Variation of the Atlas: A Microsurgical Cadaveric Study and Review of the Literature

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