Anatomic and radiologic analysis of the atlantal part of the vertebral artery

Cengiz, Şahika Liva; Çiçekcibaşı, Aynur Emine; Kocaoğullar, Yalçın; Çiçek, Onur; Baysefer, Alper; Büyükmumcu, Mustafa

doi:10.1016/j.jocn.2008.05.033

Cited by 12 publications

(6 citation statements)

References 15 publications

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“…After this date, some important progress was achieved in parallel with hardware and software advancement in computer technology as well as image processing technology in neurological radiology. according to literature records, it may be concluded that cadaveric and CT angiographic measurements are similar and overlap with each other (3,6). This may provide considerable intraoperative safety in surgical approaches related to anatomical structures such as OphA.…”

Section: █ Discussionmentioning

confidence: 76%

Three dimensional microanatomy of the ophtalmic artery: spontaneous intracranial-extracranial anastomosing site within the orbital cavity

Kuruoğlu¹,

Çokluk²,

Marangoz³

et al. 2014

Turkish Neurosurgery

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The volume rendering technique may be used in the threedimensional evaluation of some anatomical structures such as Opha. The volume rendering technique is a group of modalities in the conversion of two-dimensional images to threedimensional images (2, 5, 12). The two-dimensional images acquired by computerized tomography (CT) and magnetic resonance imaging is used to create the volume rendered images (2, 4, 5). Three-dimensional (3D) reconstructed images accurately reflect the real measurement in patients who have undergone multislice helical CT examination (15). In this study, we used the OsiriX software program for volume rendering technique to create three-dimensional ophthalmic artery images. The results of this study and the feasibility of this technique are discussed under the light of published medical literature. █ InTRODuCTIOnThe ophthalmic artery (OphA) is the first branch of the internal carotid artery distal to the cavernous sinus. The OphA supplies the structures within the orbit as well as some structures in the nose, face and meninges. The Opha arises from the internal carotid along the medial side of the anterior clinoid process and runs anteriorly passing through the optic canal inferolaterally to the optic nerve. The central retinal artery (CRA) is the first, and one of the smaller branches of the OphA. The next branch of the OphA is the lacrimal artery. It is one of the largest branches within the orbital cavity.The supraorbital artery is the second major branch of the OphA. Around the supraorbital notch, the OphA has some critical spontaneous intracranial-extracranial anastomoses with the terminal branches of the facial artery. AIM:The aim was to evaluate three-dimensional structure of the ophthalmic artery (Opha). MATERIAl and METhODS:The raw data of the Three-dimensional Computerized Tomography Angiography (3D-CTA) were transferred to computer and recorded in a software program. RESulTS:The study group consisted of 45 (24 female and 21 male) patients. The mean age of the patients was 56±9.5 years. It was found that the entry point of the OphA to the orbital cavity was inferior to the optic foramen in 29 (64.44%) of the cases. The length of the postcanalicular-prelacrimal was 0.54±0.13 centimeters at the right side and 0.51±0.13 centimeters at the left side. The distance of the postlacrimal-presupraorbital segment was 0.43±0.11 centimeters at the right and left sides. The location of the anastomosing site was 0.97± 0.42 centimeters from the supraorbital notch. COnCluSIOn:The results of this study showed us that this technique could be used in the evaluation of the three-dimensional microsurgical anatomy of the OphA and its critical extracranial-intracranial anastomosing site.

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Section: █ Discussionmentioning

confidence: 76%

Three dimensional microanatomy of the ophtalmic artery: spontaneous intracranial-extracranial anastomosing site within the orbital cavity

Kuruoğlu¹,

Çokluk²,

Marangoz³

et al. 2014

Turkish Neurosurgery

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“…To the best of our knowledge, all previous studies regarding the course of V3, SOT, and suboccipital muscles were performed in cadavers; we found no clinical studies. [ 4 , 5 , 10 , 11 , 16 , 17 , 26 , 27 , 30 ] We evaluated the anatomy of the V3 relative to the SOT, SO, IO, and RCPM in clinical cases while the far lateral approach was performed to treat VA and PICA aneurysms. Thus, our study is the first to regard the anatomy of the V3 and surrounding muscles in clinical cases with detailed descriptions of surgical techniques.…”

Section: Discussionmentioning

confidence: 99%

Course of the V3 segment of the vertebral artery relative to the suboccipital triangle as an anatomical marker for a safe far lateral approach: A retrospective clinical study

Sriamornrattanakul

Akharathammachote

Chonhenchob

et al. 2022

Surgical Neurology International

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Background: The third segment of the vertebral artery (V3) is vulnerable during far lateral and retrosigmoid approaches. Although the suboccipital triangle (SOT) is a useful anatomical landmark, the relationship between V3 and the muscles forming the triangle is not well-described. We aimed to demonstrate the relationship between the V3, surrounding muscles, and SOT in clinical cases. Methods: Operative videos of patients with the vertebral artery (VA) and posterior inferior cerebellar artery (PICA) aneurysms treated with occipital artery-PICA bypass through the far lateral approach were examined. Videos from January 2015 to October 2021 were retrospectively reviewed to determine anatomy of the V3 and the SOT. Results: Fourteen patients were included in this study. The ipsilateral V3 was identified without injury in all patients using the bipolar cutting technique. The lateral 68.2% of the horizontal V3 segment, including the V3 bulge, was covered by the inferomedial part of the superior oblique muscle (SO). The medial 23.9% was covered by the inferolateral part of the rectus capitis posterior major muscle. The inferomedial part of the horizontal V3 segment is located within the SOT. Conclusion: Most of the V3, including the V3 bulge, were located beneath the SO and the inferomedial part of V3 located within the SOT. Elevation of the SO should be performed carefully using the bipolar cutting technique to avoid injury to the V3. To the best of our knowledge, this is the first description of the V3 relative to the SOT in the clinical setting.

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“…The site of injury was visualized and the stent was placed across the rent A vertical portion between the transverse processes of C2 and C1; a horizontal portion (V3 h) in the groove of the posterior arch of the atlas; and an oblique portion where it leaves this groove and travels up to the dura mater. [2][3][4] In a study on cadavers and on healthy individuals, Cengiz et al found that the mean distance of the medial tip of the VA to the midpoint of the posterior tubercle of the atlas was 1.67 cm (in cadavers in both right and left VA) and 1.76 cm (right VA in healthy individuals) and 1.72 cm (left VA in healthy individuals). [1] In a similar study by Cacciola et al, the distance between the medial most tip of the VA and the midline was 14.3 mm to 19.7 mm.…”

Section: Discussionmentioning

confidence: 99%

Atlanto-axial dislocation associated with anomalous single vertebral artery and agenesis of unilateral internal carotid artery

et al. 2013

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We report a case of an anomalous single midline vertebral artery (VA) in a case of atlanto-axial dislocation (AAD). The left VA coursed in the midline at craniovertebral junction as there was no right VA. The left internal carotid artery was also not formed. This was a case report of a 34-year-old male patient who presented with features of high cervical myelopathy. On evaluation, he had fixed AAD. There was inadvertent intra-operative VA injury, which was sealed to control the brisk bleeding to require stenting ultimately. Patient did not survive and expired after 5 days due to brain edema secondary to compromised anomalous intracranial circulation.

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Anatomic and radiologic analysis of the atlantal part of the vertebral artery

Cited by 12 publications

References 15 publications

Three dimensional microanatomy of the ophtalmic artery: spontaneous intracranial-extracranial anastomosing site within the orbital cavity

Three dimensional microanatomy of the ophtalmic artery: spontaneous intracranial-extracranial anastomosing site within the orbital cavity

Course of the V3 segment of the vertebral artery relative to the suboccipital triangle as an anatomical marker for a safe far lateral approach: A retrospective clinical study

Atlanto-axial dislocation associated with anomalous single vertebral artery and agenesis of unilateral internal carotid artery

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