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Child's Nervous System

, Volume 35, Issue 4, pp 683–687 | Cite as

Vertebral artery segment at the suboccipital dural penetration site: an anatomical study using magnetic resonance imaging

  • Satoshi TsutsumiEmail author
  • Hideo Ono
  • Hisato Ishii
  • Yukimasa Yasumoto
Original Article

Abstract

Purpose

The morphology of the vertebral artery (VA) segment at the suboccipital dural penetration site has little been explored with magnetic resonance imaging (MRI). Therefore, the aim of this study was to examine the structure using MRI.

Methods

In total, 94 patients underwent thin-sliced, contrast MRI in the axial, coronal, and sagittal planes involving the atlas, axis, occipital bone, and V3 and V4 segments of the VA.

Results

The VA segment at the suboccipital dural penetration site was well-delineated in 93% on the axial images and in 95% on the coronal images. The axial images showed that 82% of the VA penetration sites were located in the middle third of the dural sac. Meanwhile, the coronal images revealed that the heights of both VA penetration sites were located at the same level in 87%. The axial VA penetration angle, which is formed by the VA and tangential line of the dural sac, was 66 ± 11.9° on the right side and 61 ± 14.1° on the left side. The coronal VA penetration angle, which is formed by the tangential line of the VA and dural sac, was 111 ± 24.6° on the right side and 112 ± 19.9° on the left side.

Conclusions

The morphology of the VA segment is considerably variable at the suboccipital dural penetration site, while most penetration sites are located in the middle third of the dural sac on axial MRI. These should be assumed during surgeries around the suboccipital VA penetration site.

Keywords

Vertebral artery Suboccipital Dural penetration MRI 

Notes

Author contributions

ST conceptualized the project of the study.

HI and YY collected the imaging data.

HO and HI analyzed the imaging data.

ST wrote the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Abd el-Bary TH, Dujovny M, Ausman JI (1995) Microsurgical anatomy of the atlantal part of the vertebral artery. Surg Neurol 44(4):392–401CrossRefGoogle Scholar
  2. 2.
    Akar Z, Kafadar AM, Tanriover N, Dashti RS, Islak C, Kocer N, Kuday C (2000) Rotational compression of the vertebral artery at the point of dural penetration. Case report J Neurosurg 93(2 Suppl):300–303Google Scholar
  3. 3.
    Arnautović KI, al-Mefty O, Pait TG, Krisht AF, Husain MM (1997) The suboccipital cavernous sinus. J Neurosurg 86(2):252–262CrossRefGoogle Scholar
  4. 4.
    Arnold M, Bousser MG, Fahrni G, Fischer U, Georgiadis D, Gandjour J, Benninger D, Sturzenegger M, Mattle HP, Baumgartner RW (2006) Vertebral artery dissection: presenting findings and predictors of outcome. Stroke 37(10):2499–2503CrossRefGoogle Scholar
  5. 5.
    Cengiz SL, Cicekcibasi A, Kiresi D, Kocaogullar Y, Cicek O, Baysefer A, Buyukmumcu M (2009) Anatomic and radiologic analysis of the atlantal part of the vertebral artery. J Clin Neurosci 16(5):675–678CrossRefGoogle Scholar
  6. 6.
    Duan S, Lv S, Ye F, Lin Q (2009) Imaging anatomy and variation of vertebral artery and bone structure at craniocervical junction. Eur Spine 18(8):1102–1108CrossRefGoogle Scholar
  7. 7.
    Fortuniak J, Bobeff E, Polguj M, Kośla K, Stefańczyk L, Jascólski DJ (2016) Anatomical anomalies of the V3 segment of the vertebral artery in the Polish population. Eur Spine 25(12):4164–4170CrossRefGoogle Scholar
  8. 8.
    Ha YS, Cho KH, Abe S, Abe H, Rodriguez-Vázquez JF, Murakami G (2013) Early development of the human vertebral artery especially at and above the occipitovertebral junction. Surg Radiol Anat 35(9):765–773CrossRefGoogle Scholar
  9. 9.
    Kim KS (2016) Developmental anomalies of the distal vertebral artery and posterior inferior cerebellar artery: diagnosis by CT angiography and literature review. Surg Radiol Anat 38(9):997–1006CrossRefGoogle Scholar
  10. 10.
    Kiresi D, Gumus S, Cengiz SL, Cicekcibasi A (2009) The morphometric analysis of the V2 and V3 segments of the vertebral artery: normal values on MDCT. Comput Med Imaging Graph 33(5):399–407CrossRefGoogle Scholar
  11. 11.
    Peltier J, Toussaint P, Deramond H, Gondry C, Bruniau A, Gontier MF, Le Gars D (2003) The dural crossing of the vertebral artery. Surg Radiol Anat 25(3–4):305–310CrossRefGoogle Scholar
  12. 12.
    Piffer CR, Zorzetto NL (1980) Microscopy anatomy of the vertebral artery in the suboccipital and intracranial segments. Anat Anz 147(4):382–388Google Scholar
  13. 13.
    Provenzale JM, Morgenlander JC, Gress D (1996) Spontaneous vertebral dissection; clinical, conventions angiographic, CT and MR findings. J Comput Assist Tomogr 20(2):185–193CrossRefGoogle Scholar
  14. 14.
    Rojas S, Ortega M, RodríGuez-Baeza A (2018) Variable anatomic configuration of the posterior spinal arteries in humans. Clin Anat 31(8):1137–1143CrossRefGoogle Scholar
  15. 15.
    Tubbs RS, Shah NA, Sullivan BP, Marchase ND, Cohen-Gadol AA (2009) Surgical anatomy and quantitation of the branches of the V2 and V3 segments of the vertebral artery. Laboratory investigation. J Neurosurg Spine 11(1):84–87CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Satoshi Tsutsumi
    • 1
    Email author
  • Hideo Ono
    • 2
  • Hisato Ishii
    • 1
  • Yukimasa Yasumoto
    • 1
  1. 1.Department of Neurological SurgeryJuntendo University Urayasu HospitalUrayasuJapan
  2. 2.Division of Radiological TechnologyMedical Satellite Yaesu ClinicTokyoJapan

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