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Vertebral and Branch Artery Variations
Kevin R. Moore, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Definitions

              • Arterial duplication: Division of artery into 2 distinct vessels with different courses
              • Arterial fenestration: Single arterial lumen divides into 2 parallel channels following same course
                • Frequently confused with duplication

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Gross Pathologic & Surgical Features

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              DIAGNOSTIC CHECKLIST

                              • Consider

                                Selected References

                                1. Morita T et al: [An operated case of a ruptured aneurysm arising from fenestration of the vertebral artery.] No Shinkei Geka. 40(3):221-7, 2012
                                2. Uchino A et al: Vertebral artery variations at the C1-2 level diagnosed by magnetic resonance angiography. Neuroradiology. 54(1):19-23, 2012
                                3. Bentura JE et al: Vertebrobasilar artery junction aneurysm associated with fenestration. Arq Neuropsiquiatr. 68(2):312-4, 2010
                                4. Hsu DP et al: Anomalous vertebral artery origins: the first and second reports of two variants. J Neurointerv Surg. 2(2):160-2, 2010
                                5. Albanese E et al: Fenestrated vertebrobasilar junction aneurysm: diagnostic and therapeutic considerations. J Neurosurg. 110(3):525-9, 2009
                                6. Bell R et al: Neurovascular anatomy: a practical guide. Neurosurg Clin N Am. 20(3):265-78, 2009
                                7. Yamazaki M et al: Abnormal course of the vertebral artery at the craniovertebral junction in patients with Down syndrome visualized by three-dimensional CT angiography. Neuroradiology. 50(6):485-90, 2008
                                8. Satti SR et al: Cervical vertebral artery variations: an anatomic study. AJNR Am J Neuroradiol. 28(5):976-80, 2007
                                9. Siclari F et al: Developmental anatomy of the distal vertebral artery in relationship to variants of the posterior and lateral spinal arterial systems. AJNR Am J Neuroradiol. 28(6):1185-90, 2007
                                10. Ionete C et al: MR angiographic demonstration of bilateral duplication of the extracranial vertebral artery: unusual course and review of the literature. AJNR Am J Neuroradiol. 27(6):1304-6, 2006
                                11. Chng SM et al: "Duplicated" or "multiple" cervical internal carotid and vertebral arteries from fenestration, duplication and vasa vasorum to segmental rete. Interv Neuroradiol. 10(4):301-7, 2004
                                12. Jinkins JR: Atlas of Neuroradiologic Embryology, Anatomy, and Variants. Philadelphia: Lippincott Wilkins and Wilkins. 330-3, 362-3, 2000
                                13. Morris P: Practical Neuroangiography. Baltimore: Williams and Wilkins. 153-5, 203-9, 215-8,1997
                                Related Anatomy
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                                Related Differential Diagnoses
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                                References
                                Tables

                                Tables

                                KEY FACTS

                                • Terminology

                                  • Imaging

                                    • Pathology

                                      • Clinical Issues

                                        • Diagnostic Checklist

                                          TERMINOLOGY

                                          • Definitions

                                            • Arterial duplication: Division of artery into 2 distinct vessels with different courses
                                            • Arterial fenestration: Single arterial lumen divides into 2 parallel channels following same course
                                              • Frequently confused with duplication

                                          IMAGING

                                          • General Features

                                            • CT Findings

                                              • MR Findings

                                                • Ultrasonographic Findings

                                                  DIFFERENTIAL DIAGNOSIS

                                                    PATHOLOGY

                                                    • General Features

                                                      • Gross Pathologic & Surgical Features

                                                        CLINICAL ISSUES

                                                        • Presentation

                                                          • Demographics

                                                            DIAGNOSTIC CHECKLIST

                                                            • Consider

                                                              Selected References

                                                              1. Morita T et al: [An operated case of a ruptured aneurysm arising from fenestration of the vertebral artery.] No Shinkei Geka. 40(3):221-7, 2012
                                                              2. Uchino A et al: Vertebral artery variations at the C1-2 level diagnosed by magnetic resonance angiography. Neuroradiology. 54(1):19-23, 2012
                                                              3. Bentura JE et al: Vertebrobasilar artery junction aneurysm associated with fenestration. Arq Neuropsiquiatr. 68(2):312-4, 2010
                                                              4. Hsu DP et al: Anomalous vertebral artery origins: the first and second reports of two variants. J Neurointerv Surg. 2(2):160-2, 2010
                                                              5. Albanese E et al: Fenestrated vertebrobasilar junction aneurysm: diagnostic and therapeutic considerations. J Neurosurg. 110(3):525-9, 2009
                                                              6. Bell R et al: Neurovascular anatomy: a practical guide. Neurosurg Clin N Am. 20(3):265-78, 2009
                                                              7. Yamazaki M et al: Abnormal course of the vertebral artery at the craniovertebral junction in patients with Down syndrome visualized by three-dimensional CT angiography. Neuroradiology. 50(6):485-90, 2008
                                                              8. Satti SR et al: Cervical vertebral artery variations: an anatomic study. AJNR Am J Neuroradiol. 28(5):976-80, 2007
                                                              9. Siclari F et al: Developmental anatomy of the distal vertebral artery in relationship to variants of the posterior and lateral spinal arterial systems. AJNR Am J Neuroradiol. 28(6):1185-90, 2007
                                                              10. Ionete C et al: MR angiographic demonstration of bilateral duplication of the extracranial vertebral artery: unusual course and review of the literature. AJNR Am J Neuroradiol. 27(6):1304-6, 2006
                                                              11. Chng SM et al: "Duplicated" or "multiple" cervical internal carotid and vertebral arteries from fenestration, duplication and vasa vasorum to segmental rete. Interv Neuroradiol. 10(4):301-7, 2004
                                                              12. Jinkins JR: Atlas of Neuroradiologic Embryology, Anatomy, and Variants. Philadelphia: Lippincott Wilkins and Wilkins. 330-3, 362-3, 2000
                                                              13. Morris P: Practical Neuroangiography. Baltimore: Williams and Wilkins. 153-5, 203-9, 215-8,1997