Republished: Multiple anomalies in the origin and course of vertebral arteries and aberrant right subclavian artery in a child with moyamoya syndrome

Abstract

Here we report, for the first time, a combination of five-vessel aortic arch, anomalous origin of the right vertebral artery (VA) from the common carotid artery (CCA), an aberrant right subclavian artery (SCA), and bilateral symmetrical segmental agenesis of VAs.In this case report, we present a patient with moyamoya syndrome (MMS) and Down syndrome (DS) who has bilateral symmetrical segmental agenesis of VAs, left VA originating from aortic arch and anomalous origin of right VA arising from CCA in combination with an aberrant right SCA. Therefore, five vessels are originating from aortic arch. Here, we report, for the first time, a combination of five-vessel aortic arch with an aberrant right SCA and symmetrical segmental agenesis of both VAs. The possible embryological mechanisms of the anomalies as well as an relation with MMS and DS are discussed.

Case report: Right vertebral and carotid artery anomalies with an aberrant right subclavian artery in two patients

“…In contrast, variations in the origin of the RVA are less common, with an incidence rate of 0.18% (1). If the RVA arises from the RCCA, its association with RSCA abnormalities also increases (5)(6)(7)(8). Although the embryology of abnormal RVA and RSCA is complex, understanding embryonic development and branching patterns can help explain these abnormalities.…”

Imaging Challenges in the Diagnosis of Anatomical Variations of the Supra-Aortic Vessels: A Case Report and Review of Literature

“…Usually, the left vertebral artery arises from the left subclavian artery medial to the thyrocervical trunk. Variations in the aortic arch are described in the literature; the condition when an anomalous left vertebral artery arises directly from the aortic arch is known as “Adachi TYPE C” variation [ 12 , 13 ]. Its prevalence is reported to be between 0.68% and 5.8%, having a female predominance [ 11 ].…”

“…Additionally, this variation is more commonly observed in women [ 14 ]. It may remain asymptomatic, but it may present with various clinical syndromes such as ischemic stroke, transient or permanent motor deficits, central sleep apnea, trigeminal neuralgia, or hydrocephalus [ 12 , 13 , 14 ]. Lusoria artery or aberrant right subclavian artery (ARSA) is another rare aortic arch branching anomaly, present in 0.4–1.8% of the general population.…”