Articles: vertebral-artery-abnormalities.
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Review Case Reports
Atypical Course of Vertebral Artery Outside the Cervical Spine: Case Report and Review of the Literature.
The 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. ⋯ Variability 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.
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Bow hunter's syndrome (BHS) should not be overlooked as a cause of cerebral infarction in the posterior circulation. However, covert BHS, which does not impair blood flow with simple rotation but only at certain angles, may make the diagnosis of BHS difficult. We propose a new algorithm to detect BHS or covert BHS. We recommend that BHS and covert BHS be detected by noninvasive duplex ultrasonography, which will allow for appropriate treatment.
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Review Case Reports
Surgical interventions for cervical radiculopathy caused by a vertebral artery loop.
Aberrant vertebral artery loops are a rare clinical condition, with sparse data regarding the optimal treatment guidelines for individual patients. The heterogeneity of treatment options in the literature creates a problem when tailoring treatments to individual patients. In this review of the literature, multiple surgical treatments for cervical vertebral artery loops were analyzed and compared. In addition, this article provides a clinical case of a patient with a vertebral artery loop. ⋯ Multiple successful surgical interventions have been described in the medical literature. However, because of the lack of evidence-based studies, no surgical intervention protocol could be determined. Treatment should therefore be tailored to individual patients' characteristics. Because not every radiologically detected vertebral artery loop is the main reason for a patient's symptoms, a thorough multidisciplinary approach is justified and advocated in patients with an atypical presentation, before a neurosurgical intervention takes place. More deliberate clinical decisions can be made once the understanding of the pathogenesis of this rare disease entity has been established and treatment protocols formulated.
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The posterior inferior cerebellar artery (PICA), with its unique anatomical complexity, is of great clinical importance and involved in many diseases including aneurysm, ischemic stroke, neurovascular compression syndrome (NVCS), arteriovenous malformation (AVM), and brain tumor. However, a comprehensive systematic review of the importance of the PICA is currently lacking. In this study, we perform a literature review of PICA by searching all the associated papers in the PUBMED database hoping to provide a better understanding of the artery. ⋯ The PICA supplies many brain tumors and can be used in intracerebellar chemotherapy. The PICA can be exposed and injured during surgeries especially in telovelar approach, and it also plays an important role in bypass surgeries, hinting the surgical importance of PICA. In conclusion, PICA is very important in clinical practice.
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Review Case Reports
Extraforaminal vertebral artery until the C2 transverse foramen in Down syndrome patient affected by atloaxial subluxation. First observation and review of the literature.
Patients with Down syndrome (DS) have an increased incidence of multisystem disorders, like cardiovascular, neurologic, gastrointestinal, respiratory, and musculoskeletal disorders. Craniovertebral junction instability is a common illness in DS patients, and they may often be affected by vertebral artery (VA) anomalies. ⋯ We reviewed the literature about the incidence of anatomic variations of the V2 segment in both the general population and the one affected by DS, and although numerous cases of anomalous course, none reported a C2 TF entry point. Ignoring such extremely rare anatomic variation during anterior, posterior, or lateral surgical approach to the cervical spine can lead to inadvertent injury and potentially serious complications like arterial dissection, thrombus, vascular spasm, fistula, pseudoaneurysm, cerebral ischemia, and death.