link
Bookmarks
Persistent First Intersegmental Artery
Kevin R. Moore, MD; Jeffrey S. Ross, MD
To access 4,300 diagnoses written by the world's leading experts in radiology, please log in or subscribe.Log inSubscribe
0
3
1
0

KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Definitions

                • Anatomic variation of V3 segment of vertebral artery (VA) coursing into spinal canal below C1 arch level, at C1-C2
                • Unilateral in up to 4% of individuals
                • Bilateral persistence is uncommon (< 1%)

              IMAGING

              • General Features

                • CT Findings

                  • MR Findings

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        CLINICAL ISSUES

                        • Presentation

                          DIAGNOSTIC CHECKLIST

                          • Consider

                            Selected References

                            1. Kashiro H et al: Atlantoaxial fixation in a patient with bilateral persistent first intersegmental vertebral artery anomaly using an O-arm navigation system: a case report. Spine Surg Relat Res. 3(2):196-8, 2019
                            2. Zhang H et al: Persistent first intersegmental artery (PFIA) visualized by three-dimensional computed tomography angiography in Chinese population. Int J Surg. 52:233-6, 2018
                            3. Buch VP et al: Rotational vertebrobasilar insufficiency due to compression of a persistent first intersegmental vertebral artery variant: case report. J Neurosurg Spine. 26(2):199-202, 2017
                            4. Patra DP et al: Redundant anomalous vertebral artery in a case of congenital irreducible atlantoaxial dislocation: Emphasizing on the differences from the first intersegemental artery and operative steps to prevent injury while performing C1-2 joint manipulation. Ann Neurosci. 22(4):245-7, 2015
                            5. OʼDonnell CM et al: Vertebral artery anomalies at the craniovertebral junction in the US population. Spine (Phila Pa 1976). 39(18):E1053-7, 2014
                            6. Nakashima K et al: Persistent primitive first cervical intersegmental artery (proatlantal artery II) associated with subarachnoid hemorrhage of unknown origin. Clin Neurol Neurosurg. 114(1):90-2, 2012
                            7. Uchino A et al: Vertebral artery variations at the C1-2 level diagnosed by magnetic resonance angiography. Neuroradiology. 54(1):19-23, 2012
                            8. Hong JT et al: Posterior C1 stabilization using superior lateral mass as an entry point in a case with vertebral artery anomaly: technical case report. Neurosurgery. 68(1 Suppl Operative):246-9; discussion 249, 2011
                            9. Lee SH et al: Posterior C1-2 fusion using a polyaxial screw/rod system for os odontoideum with bilateral persistence of the first intersegmental artery. J Neurosurg Spine. 14(1):10-3, 2011
                            10. Tubbs RS et al: Persistent fetal intracranial arteries: a comprehensive review of anatomical and clinical significance. J Neurosurg. 114(4):1127-34, 2011
                            11. Carmody MA et al: Persistent first intersegmental vertebral artery in association with type II odontoid fracture: surgical treatment utilizing a novel C1 posterior arch screw: case report. Neurosurgery. 67(1):210-1; discussion 211, 2010
                            12. Ulm AJ et al: Normal anatomical variations of the V₃ segment of the vertebral artery: surgical implications. J Neurosurg Spine. 13(4):451-60, 2010
                            13. Yamazaki M et al: Anomalous vertebral artery at the extraosseous and intraosseous regions of the craniovertebral junction: analysis by three-dimensional computed tomography angiography. Spine (Phila Pa 1976). 30(21):2452-7, 2005
                            Related Anatomy
                            Loading...
                            Related Differential Diagnoses
                            Loading...
                            References
                            Tables

                            Tables

                            KEY FACTS

                            • Terminology

                              • Imaging

                                • Top Differential Diagnoses

                                  • Pathology

                                    • Clinical Issues

                                      • Diagnostic Checklist

                                        TERMINOLOGY

                                        • Definitions

                                          • Anatomic variation of V3 segment of vertebral artery (VA) coursing into spinal canal below C1 arch level, at C1-C2
                                          • Unilateral in up to 4% of individuals
                                          • Bilateral persistence is uncommon (< 1%)

                                        IMAGING

                                        • General Features

                                          • CT Findings

                                            • MR Findings

                                              DIFFERENTIAL DIAGNOSIS

                                                PATHOLOGY

                                                • General Features

                                                  CLINICAL ISSUES

                                                  • Presentation

                                                    DIAGNOSTIC CHECKLIST

                                                    • Consider

                                                      Selected References

                                                      1. Kashiro H et al: Atlantoaxial fixation in a patient with bilateral persistent first intersegmental vertebral artery anomaly using an O-arm navigation system: a case report. Spine Surg Relat Res. 3(2):196-8, 2019
                                                      2. Zhang H et al: Persistent first intersegmental artery (PFIA) visualized by three-dimensional computed tomography angiography in Chinese population. Int J Surg. 52:233-6, 2018
                                                      3. Buch VP et al: Rotational vertebrobasilar insufficiency due to compression of a persistent first intersegmental vertebral artery variant: case report. J Neurosurg Spine. 26(2):199-202, 2017
                                                      4. Patra DP et al: Redundant anomalous vertebral artery in a case of congenital irreducible atlantoaxial dislocation: Emphasizing on the differences from the first intersegemental artery and operative steps to prevent injury while performing C1-2 joint manipulation. Ann Neurosci. 22(4):245-7, 2015
                                                      5. OʼDonnell CM et al: Vertebral artery anomalies at the craniovertebral junction in the US population. Spine (Phila Pa 1976). 39(18):E1053-7, 2014
                                                      6. Nakashima K et al: Persistent primitive first cervical intersegmental artery (proatlantal artery II) associated with subarachnoid hemorrhage of unknown origin. Clin Neurol Neurosurg. 114(1):90-2, 2012
                                                      7. Uchino A et al: Vertebral artery variations at the C1-2 level diagnosed by magnetic resonance angiography. Neuroradiology. 54(1):19-23, 2012
                                                      8. Hong JT et al: Posterior C1 stabilization using superior lateral mass as an entry point in a case with vertebral artery anomaly: technical case report. Neurosurgery. 68(1 Suppl Operative):246-9; discussion 249, 2011
                                                      9. Lee SH et al: Posterior C1-2 fusion using a polyaxial screw/rod system for os odontoideum with bilateral persistence of the first intersegmental artery. J Neurosurg Spine. 14(1):10-3, 2011
                                                      10. Tubbs RS et al: Persistent fetal intracranial arteries: a comprehensive review of anatomical and clinical significance. J Neurosurg. 114(4):1127-34, 2011
                                                      11. Carmody MA et al: Persistent first intersegmental vertebral artery in association with type II odontoid fracture: surgical treatment utilizing a novel C1 posterior arch screw: case report. Neurosurgery. 67(1):210-1; discussion 211, 2010
                                                      12. Ulm AJ et al: Normal anatomical variations of the V₃ segment of the vertebral artery: surgical implications. J Neurosurg Spine. 13(4):451-60, 2010
                                                      13. Yamazaki M et al: Anomalous vertebral artery at the extraosseous and intraosseous regions of the craniovertebral junction: analysis by three-dimensional computed tomography angiography. Spine (Phila Pa 1976). 30(21):2452-7, 2005