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Persistent First Intersegmental Artery
Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          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

                      Selected References

                      1. OʼDonnell CM et al: Vertebral artery anomalies at the craniovertebral junction in the US population. Spine (Phila Pa 1976). 39(18):E1053-7, 2014
                      2. 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
                      3. Uchino A et al: Vertebral artery variations at the C1-2 level diagnosed by magnetic resonance angiography. Neuroradiology. 54(1):19-23, 2012
                      4. 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
                      5. 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
                      6. Tubbs RS et al: Persistent fetal intracranial arteries: a comprehensive review of anatomical and clinical significance. J Neurosurg. 114(4):1127-34, 2011
                      7. 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
                      8. 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
                      9. 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
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                      Related Differential Diagnoses
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                      References
                      Tables

                      Tables

                      KEY FACTS

                      • Terminology

                        • Imaging

                          • Top Differential Diagnoses

                            • Clinical Issues

                              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

                                          Selected References

                                          1. OʼDonnell CM et al: Vertebral artery anomalies at the craniovertebral junction in the US population. Spine (Phila Pa 1976). 39(18):E1053-7, 2014
                                          2. 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
                                          3. Uchino A et al: Vertebral artery variations at the C1-2 level diagnosed by magnetic resonance angiography. Neuroradiology. 54(1):19-23, 2012
                                          4. 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
                                          5. 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
                                          6. Tubbs RS et al: Persistent fetal intracranial arteries: a comprehensive review of anatomical and clinical significance. J Neurosurg. 114(4):1127-34, 2011
                                          7. 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
                                          8. 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
                                          9. 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