Abstract
Introduction: A thorough understanding of the vertebral artery (VA) variations and course of the artery and its related branches could significantly enhance the efficacy and safety of interventions involving the neck and spine. Here, we aimed to investigate the incidence of various VA variations in individuals presenting with signs and symptoms of stroke with our neurology team. Material and Method: In this retrospective study we investigate CTA images of patients with signs and symptom of stroke who referred to specialized medical imaging centre. An experienced board-certified radiologist evaluated the CTA images, recording the characteristics of VA, regarding dominance and any possible anomalies. These included anomalous origin, anomalous route, anomalous branching, stenosis, hypoplasia, atresia, thrombosis, and dissection. All data were analyzed using SPSS version24 and Pearson Chi-Square and Fishers test used for anomaly and gender correlation. Results: A total of 125 patients (53.6% females; mean age, 60.7 (11-87)) were included. In the case of VA dominance, 66.4% of cases were co-dominant while 16.0% were right, and 12.8% were left dominant. Overall, males had more VA anomalies than females, 24.8% and 17.6%, respectively (in general, 42.4% of all participants) (p = 0.020). Among patients, 4.0% (n = 5) had an anomalous origin and anomalous branching was reported in 5 patients (4.0%). Among the variations, significant stenosis (18.4%) and hypoplasia (17.6%) were the most prevalent anomalies with the earliest one having the higher rate. While anomalous branching was reported in 5 patients (4.0%). Conclusions: VA variations are relatively common and should be addressed during procedures involving the neck region and would allow surgeons to avoid life threatening injury.
Highlights
A thorough understanding of the vertebral artery (VA) variations and course of the artery and its related branches could significantly enhance the efficacy and safety of interventions involving the neck and spine
In the case of VA dominance, 66.4% of cases were co-dominant while 16.0% were right, and 12.8% were left dominant
We assess the prevalence of VA anomalies according to data from computed tomography (CT) Angiography of patients who referred to the neurology team with signs and symptoms of posterior inferior cerebellar artery (PICA) stroke
Summary
A thorough understanding of the vertebral artery (VA) variations and course of the artery and its related branches could significantly enhance the efficacy and safety of interventions involving the neck and spine. We aimed to investigate the incidence of various VA variations in individuals presenting with signs and symptoms of stroke with our neurology team. The VA is anatomically divided into four segments: V1, preforaminal; V2, foraminal; V3, atlantic; and V4 intracranial [2]. In Kauffman’s study, it was reported that patients with VA stenotic origin are correlated with less risk of stroke through intraarterial angiography [5]. The VA origin and aortic arch branching patterns should be assessed in cases of cerebrovascular accidents and VA dissection [6]
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