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Vertebral Artery Fenestration.

Ozpinar A, Magill ST, Davies JM, McDermott MW - Cureus (2015)

Bottom Line: It is most commonly seen in the extracranial segments of the vertebral artery.This congenital anomaly can arise during multiple different stages of embryological development of the vertebral artery.Awareness of vascular anomalies is crucial to avoid iatrogenic injuries during endovascular diagnostic and therapeutic interventions.

View Article: PubMed Central - HTML - PubMed

Affiliation: Neurological Surgery, Oregon Health & Science University.

ABSTRACT
Fenestration of the vertebral artery is a rare vascular anomaly that has been observed at autopsy and on angiography. It is most commonly seen in the extracranial segments of the vertebral artery. This congenital anomaly can arise during multiple different stages of embryological development of the vertebral artery. The clinical significance is unclear, but multiple studies have reported association with other vascular anomalies. Awareness of vascular anomalies is crucial to avoid iatrogenic injuries during endovascular diagnostic and therapeutic interventions. Here, we present a case of a patient with an intracranial vertebral artery fenestration that was identified during work-up for a foramen magnum mass.

No MeSH data available.


Related in: MedlinePlus

Radiographic and Intraoperative Images of Fenestrated Vertebral ArteryMRA time of flight study demonstrating rotated views of the vertebrobasilar circulation. The right vertebral artery demonstrates fenestration in the V4 segment (A-C). Intraoperative photo demonstrating intradural origin and fenestration of the right vertebral artery (D).
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FIG1: Radiographic and Intraoperative Images of Fenestrated Vertebral ArteryMRA time of flight study demonstrating rotated views of the vertebrobasilar circulation. The right vertebral artery demonstrates fenestration in the V4 segment (A-C). Intraoperative photo demonstrating intradural origin and fenestration of the right vertebral artery (D).

Mentions: A 76-year-old gentleman with no significant medical history presented to our clinic with two years of suboccipital headaches and worsening trapezius wasting. Preoperative MRI revealed a foramen magnum mass intimately associated with the right accessory nerve. The patient did not have evidence of other vascular anomalies. He underwent a far lateral craniotomy and resection of the tumor. The right vertebral artery was visualized intraoperatively with a fenestration extending from the intradural origin at the foramen magnum superiorly towards the vertebrobasilar junction. Postoperative MRI/MRA demonstrated gross total resection of the tumor and confirmed the presence of a vertebral artery with fenestration of the intradural V4 segment extending superiorly toward the vertebrobasilar junction where the two channels eventually re-fused. Figure 1 shows a time-of-flight MRA demonstrating fenestration of the right vertebral artery (Figures 1A-1C) as well as an intraoperative view of the intradural origin of the artery (Figure 1D).


Vertebral Artery Fenestration.

Ozpinar A, Magill ST, Davies JM, McDermott MW - Cureus (2015)

Radiographic and Intraoperative Images of Fenestrated Vertebral ArteryMRA time of flight study demonstrating rotated views of the vertebrobasilar circulation. The right vertebral artery demonstrates fenestration in the V4 segment (A-C). Intraoperative photo demonstrating intradural origin and fenestration of the right vertebral artery (D).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4494529&req=5

FIG1: Radiographic and Intraoperative Images of Fenestrated Vertebral ArteryMRA time of flight study demonstrating rotated views of the vertebrobasilar circulation. The right vertebral artery demonstrates fenestration in the V4 segment (A-C). Intraoperative photo demonstrating intradural origin and fenestration of the right vertebral artery (D).
Mentions: A 76-year-old gentleman with no significant medical history presented to our clinic with two years of suboccipital headaches and worsening trapezius wasting. Preoperative MRI revealed a foramen magnum mass intimately associated with the right accessory nerve. The patient did not have evidence of other vascular anomalies. He underwent a far lateral craniotomy and resection of the tumor. The right vertebral artery was visualized intraoperatively with a fenestration extending from the intradural origin at the foramen magnum superiorly towards the vertebrobasilar junction. Postoperative MRI/MRA demonstrated gross total resection of the tumor and confirmed the presence of a vertebral artery with fenestration of the intradural V4 segment extending superiorly toward the vertebrobasilar junction where the two channels eventually re-fused. Figure 1 shows a time-of-flight MRA demonstrating fenestration of the right vertebral artery (Figures 1A-1C) as well as an intraoperative view of the intradural origin of the artery (Figure 1D).

Bottom Line: It is most commonly seen in the extracranial segments of the vertebral artery.This congenital anomaly can arise during multiple different stages of embryological development of the vertebral artery.Awareness of vascular anomalies is crucial to avoid iatrogenic injuries during endovascular diagnostic and therapeutic interventions.

View Article: PubMed Central - HTML - PubMed

Affiliation: Neurological Surgery, Oregon Health & Science University.

ABSTRACT
Fenestration of the vertebral artery is a rare vascular anomaly that has been observed at autopsy and on angiography. It is most commonly seen in the extracranial segments of the vertebral artery. This congenital anomaly can arise during multiple different stages of embryological development of the vertebral artery. The clinical significance is unclear, but multiple studies have reported association with other vascular anomalies. Awareness of vascular anomalies is crucial to avoid iatrogenic injuries during endovascular diagnostic and therapeutic interventions. Here, we present a case of a patient with an intracranial vertebral artery fenestration that was identified during work-up for a foramen magnum mass.

No MeSH data available.


Related in: MedlinePlus