Acta Neurochirurgica

, Volume 160, Issue 8, pp 1621–1623 | Cite as

Bilateral persistent ‘second’ intersegmental vertebral arteries: illustrated with a case

  • Madhivanan KarthigeyanEmail author
  • Pravin Salunke
  • Mandeep Singh Kataria
Case Report - Pediatric Spine
Part of the following topical collections:
  1. Pediatric Spine


Congenital craniovertebral junction deformities can be associated with an anomalous vertebral artery (VA). At times, the artery crosses the joint posteriorly (i.e., persistent first intersegmental artery) and is at risk during posterior approach. We report a new variant, wherein the bilateral VA coursed medially after exiting the C3 transverse foramina to lie beneath C2 pars interarticularis and enter the foramen magnum (without passing through C2 transverse foramen anywhere along its course). This is possibly a result of bilateral persistent second intersegmental arteries. It is pertinent to recognize this unusual variant to avoid VA injury, especially while inserting C2 pars/transarticular screw.


Anomalous vertebral artery Persistent first intersegmental artery Posterior C2–3 fusion Pars interarticularis Congenital atlantoaxial dislocation 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of informed consent

Informed consent was obtained from patient.


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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of NeurosurgeryPostgraduate Institute of Medical Education and Research (PGIMER)ChandigarhIndia

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