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
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
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
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
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
OʼDonnell CM et al: Vertebral artery anomalies at the craniovertebral junction in the US population. Spine (Phila Pa 1976). 39(18):E1053-7, 2014
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
Uchino A et al: Vertebral artery variations at the C1-2 level diagnosed by magnetic resonance angiography. Neuroradiology. 54(1):19-23, 2012
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
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
Tubbs RS et al: Persistent fetal intracranial arteries: a comprehensive review of anatomical and clinical significance. J Neurosurg. 114(4):1127-34, 2011
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
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
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
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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
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
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
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
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
OʼDonnell CM et al: Vertebral artery anomalies at the craniovertebral junction in the US population. Spine (Phila Pa 1976). 39(18):E1053-7, 2014
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
Uchino A et al: Vertebral artery variations at the C1-2 level diagnosed by magnetic resonance angiography. Neuroradiology. 54(1):19-23, 2012
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
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
Tubbs RS et al: Persistent fetal intracranial arteries: a comprehensive review of anatomical and clinical significance. J Neurosurg. 114(4):1127-34, 2011
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
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
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
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