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

Abstract

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.

Unilateral Aplasia versus Bilateral Aplasia of the Vertebral Artery: A Review of Associated Abnormalities

“…Associated aplasia of other vessels was related to the ICA on the right side in one case [ 105 ] and on the left side in the second case [ 106 ], bilateral external carotid arteries (ECAs) in one case [ 92 ], right SA branches in one case [ 107 ], BA in one case [ 90 ], unilateral PCoA in 4 cases including recent case [ 75 , 93 , 96 ], and bilateral PCoAs in three cases [ 87 , 88 , 99 ] and the right ACA (associated with bilateral PCoA aplasia) in one case [ 88 ].…”