• Zygmunt Siedlecki, Mateusz Szostak, Karol Nowak, and Maciej Śniegocki.
• Department of Neurosurgery, Neurotraumatology and Pediatric Neurosurgery, The Ludwik Rydygier Collegium Medicum in Bydgoszcz, The Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland. Electronic address: siedlecki@cm.umk.pl.
• World Neurosurg. 2021 Jan 1; 145: 405-408.

BackgroundThe vertebral arteries are branches of the subclavian arteries supply blood to the posterior part of the encephalon, forming vertebrobasilar circulation. Disorders of vertebrobasilar circulation have significant clinical implications. Symptoms of these disorders include dizziness, vomiting, collapse, vision and cerebellar disorders. The vertebral artery usually ascends in the transverse foramina of the cervical vertebrae to reach the posterior cranial cavity by entering the magnum foramen. Although most often the vertebral artery enters the C6 transverse process, anatomic variation may occur.Case DescriptionIn this case, a 16-year-old male patient with casuistic anatomic variant of vertebral artery course is described. In this case report, left vertebral artery ascended outside the transverse foramina of cervical vertebrae C6-C3 and entered transverse foramen of axis. The patient suffered from collapse and dizziness during neck and head movements as a result of arterial folding. After rehabilitation and posture and proper movement learning, the frequency of symptoms subsided.ConclusionsVariability of the vertebral arteries may have clinical implications, and knowledge of its topography is important for mechanism of vertebrobasilar circulatory disorder understanding and for surgical approach to the cervical spine and neck anatomic structures.Copyright © 2020 Elsevier Inc. All rights reserved.

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