C2 Segmental-Type Vertebral Artery Diagnosed Using Computed Tomographic Angiography
10.3340/jkns.2017.0303.010
- Author:
Myoung Soo KIM
1
Author Information
1. Department of Neurosurgery, National Medical Center, Seoul, Korea. hanibalkms@hanmail.net
- Publication Type:Original Article
- Keywords:
Vertebral artery;
Congenital abnormalities;
Computed tomography angiography;
Infarction
- MeSH:
Aged;
Angiography;
Arteries;
Congenital Abnormalities;
Humans;
Infarction;
Pica;
Spinal Canal;
Vertebral Artery
- From:Journal of Korean Neurosurgical Society
2018;61(2):194-200
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: Sometimes a vertebral artery (VA) enters the spinal canal via the C1–2 intervertebral space, a variation regarded as a C2 segmental-type VA. This paper describes the anatomy of the C2 segmental-type VA and reviews its clinical importance.METHODS: Between March 2014 and November 2015, 3386 patients underwent computed tomographic angiography. I identified C2 segmental-type VAs, associated vascular variation, the origin of ipsilateral posterior inferior cerebellar arteries (PICAs), and the clinical symptoms associated with C2 segmental-type VAs. The origin of an ipsilateral PICA is divided into 5 types. A type 1 PICA originates from ipsilateral VAs coursing suboccipitally (IVASO), a type 2 originates from ipsilateral proximal C2 segmental-type VAs, a type 3 originates from ipsilateral distal C2 segmental-type VAs. For type 4, the PICA does not originate from an ipsilateral VA. For type 5, the PICA is the terminal end of an ipsilateral C2 segmental-type VA.RESULTS: One hundred thirteen patients had 121 C2 segmental-type VAs; 47 were associated with an IVASO, and 74 were not. Four type 1, 13 type 2, 60 type 3, 42 type 4, and two type 5 PICAs were identified. Only one patient showed symptoms associated with a C2 segmental-type VA, being a 71-year-old man presenting with a C2 segmental-type VA infarction.CONCLUSION: For C2 segmental-type VAs, the ipsilateral IVASO and origin of the PICA are important for predicting the outcome of this type of VA infarction.
