Vertebral Artery Anomaly With Atraumatic Dissection Causing Thromboembolic Ischemia

Rs, Jackson; Ah, Wheeler; Bv, Darden

doi:10.1097/00007632-200008010-00020

Cited by 20 publications

(9 citation statements)

References 12 publications

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“…The most striking finding about the vascular abnormality described in this study was the fact that, besides its abnormal origin, the right vertebral artery runs outside most of the foramina transversaria and enter at the C II level. Jackson et al (2000) described one case of a left vertebral artery entering the foramen transversarium at C III level. We found only two other descriptions in the literature with an entry at C III (Table 2).…”

Section: Discussionmentioning

confidence: 99%

Anomalous origin and cervical course of the vertebral artery in the presence of a retroesophageal right subclavian artery

2004

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The vertebral artery is usually described as the first branch of the subclavian artery, originating medial to the scalenus anterior muscle. During its cervical course, the vertebral artery presents a prevertebral segment and then enters the foramen transversarium of the sixth cervical vertebra. We describe a case of an unusual origin and course of the right vertebral artery in a cadaver specimen wherein the right vertebral artery originates from the right common carotid artery at the inferior border of the thyroid gland. In its cervical course the vertebral artery ascends outside and anteriorly to the foramen transversarium of vertebrae C VI to C III, and enters the foramen transversarium of the axis. In the same specimen, a retroesophageal right subclavian artery is also present. These vascular abnormalities are presented for physicians to keep in mind such variations during diagnostic investigation and surgical procedures of the neck.

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Section: Discussionmentioning

confidence: 99%

Anomalous origin and cervical course of the vertebral artery in the presence of a retroesophageal right subclavian artery

2004

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“…In contrast, in our cohort, the VA was affected more frequently. The course of the VA in the lateral vertebral process may account for a preference to dissections [16][17][18]. Thorough MRI and MRA investigations in all patients in the acute phase may be a reason for a high proportion of VA-dissections (n = 43) in the present cohort.…”

Section: Epidemiologymentioning

confidence: 77%

Dissections of Cervical Arteries – Clinical Presentation, Course, and Therapy in 71 Consecutive Patients of a Single University Centre

Neidhardt¹

2011

TOCCMJ

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Dissections of the cervical arteries are among the most frequent causes of juvenile strokes. The etiology and pathogenesis of spontaneous dissections remain elusive. Best treatment remains to be defined. Here, we analyzed 71 consecutive patients from the Department of Neurology, University Hospital of Jena. We asked if immediate anticoagulation or alternative treatment with ASA would affect outcome. Patients treated initially with i.v. ASA tended to have a better outcome than patients who were anticoagulated (r=0.3; p<0.05). In heparin treated patients, an initial i.v. bolus shortened the interval before the target PTT was reached by 1.3 days (p<0.05), yet did not affect neurological outcome. Low NIHSS (National Institute of Health Stroke Scale) (r=-0.71; p<0.01) and high Barthel scores (r=0,77; p<0.01) at presentation predicted a good outcome. In 14 of 52 patients, low TSH (thyroid-stimulating hormone) indicated hyperthyreosis, while no patient was hypothyreotic. In 33 of 64 patients CRP (C-reactive protein) was elevated. These findings merit validation in larger trials.

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“…Our PubMed search found only 2 previous cases with similar stroke mechanism, also in relationship with hyperextension and rotation of the patient's neck. 2,3 Occlusion or partial occlusion of the VA has been described with neck motion (bow hunter's syndrome). 4 In this condition, the dominant VA is commonly compressed at C1-C2 level and patients typically present with recurrent events of vertigo or fainting spells.…”

Section: Discussionmentioning

confidence: 99%

Posterior circulation ischemic stroke with aberrant vertebral artery cervical entrance at the C4 vertebral level

Huisa

Mathes

2014

Neur Clin Pract

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Figure 1 Case 1 (A) CT angiogram of the neck shows the right vertebral artery (VA) near its entry at the C4 level. There is a crescentfilling defect in the VA wall (black arrow). (B) Brain MRI diffusion-weighted images show bilateral posterior circulation ischemic lesions. (C) Catheter angiogram of the right VA shows the arterial wall defect suggestive of a small arterial dissection (arrow). Neurology: Clinical Practice | | | | | | | | | | | | October 2014 Neurology.org/cp 459Posterior circulation ischemic stroke with aberrant vertebral artery cervical entrance at the C4 vertebral level

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Vertebral Artery Anomaly With Atraumatic Dissection Causing Thromboembolic Ischemia

Cited by 20 publications

References 12 publications

Anomalous origin and cervical course of the vertebral artery in the presence of a retroesophageal right subclavian artery

Anomalous origin and cervical course of the vertebral artery in the presence of a retroesophageal right subclavian artery

Dissections of Cervical Arteries – Clinical Presentation, Course, and Therapy in 71 Consecutive Patients of a Single University Centre

Posterior circulation ischemic stroke with aberrant vertebral artery cervical entrance at the C4 vertebral level

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