Anatomic study of the suboccipital artery of Salmon with surgical significance

Abstract

The anatomy of the muscular branches of the vertebral arteries has clinical relevance during surgical procedures, suboccipital injections, and manual therapies. Each vertebral artery is divided into four segments. Segment V3, found in the suboccipital triangle, courses posteromedially around the lateral mass to lie in a groove on the posterior arch of the atlas, ultimately coursing beneath the posterior atlanto-occipital membrane to enter the skull. Although not always present, any muscular branch that emanates from this segment to supply the suboccipital muscles is called the suboccipital artery of Salmon. There is a paucity of literature on this artery despite its clinical relevancy. We found the suboccipital artery of Salmon in 10 (67%) of 15 embalmed adult cadavers. This frequency is considerably higher than that in previous reports. Two (20%) of the 10 cadavers demonstrated bilateral and symmetrical suboccipital arteries of Salmon (one artery on each side). Four (40%) of the 10 cadavers had an arrangement of two parallel suboccipital arteries of Salmon on one side, and one on the contralateral side. Three (30%) of the 10 cadavers displayed an asymmetrical unilateral arrangement (only one artery). One (10%) of the 10 cadavers displayed the unique arrangement of three arteries of Salmon on one side and one artery on the contralateral side. This study adds to a limited, but growing, body of knowledge by providing photographic evidence of the course and arrangement of these arteries and, therefore, can be of value to surgeons and other clinicians whose procedures focus on the suboccipital region.

The assessment of the frequency and arrangement of the subsegmental branches of V3 using computed tomography angiography

“…The frequency of the artery of Salmon was 17.07-20.21% in V3h. Our results are consistent with those reported by Tubbs RS et al Three branches arising from the V3h were discovered by dissecting cadavers (27), while no more than 2 branches were revealed in our research. The frequency of the branch was 25% in V3v and less than 6% in V3e.…”

“…The branch arising from V3h was defined as the suboccipital artery of Salmon that supplied the neighboring muscles. The frequency of the artery of Salmon was 20% in a study of 10 cadavers and 67% a study of 15 cadavers (26,27). The frequency of the artery of Salmon was 17.07-20.21% in V3h.…”

“…The vertebral artery has a tortuous shape to meet the need for flexible movement and to facilitate smooth blood flow. V3 is anatomically defined as the vertebral artery that passes from the foramen of C1 to the site of the piercing dura, and it is radiologically defined as the artery passing from the foramen of C2 to the piercing site (26,27). Considering the occipito-atlantoaxial complex is a functional complex, we adopted the latter definition.…”

“…CTA has been frequently in imaging examinations to simultaneously reveal the three-dimensional anatomy surrounding V3, as it has the advantages of being noninvasive and fast and yielding volumetric scans. Morphometric analyses of V3 performed by using CTA have been reported in many studies (19)(20)(21)(22)(23)(24), but the branches of V3 have been studied in few studies, with small sample sizes of cadavers due to the high cost and intricate procedures required (25)(26)(27). Although a large sample of vertebral arteries can be assessed by CTA, the branches of V3 have not yet been reported.…”

The V3 segment of the vertebral artery as a robust donor for intracranial-to-intracranial interpositional bypasses: technique and application in 5 patients

“…1G and H). 3,5,28 An extradural PICA and PSA both have surgical importance and must be preserved. The V 3 segment is invested in an abundant venous plexus (Fig.…”