A 48-year-old woman developed progressive right lower extremity numbness and lancinating pain of pharynx. T2-weighted MRI revealed a flow-void area that corresponded to the both aberrant vertebral arteries (persistent first intersegmental arteries) severely compressing distorting medulla oblongata tonsilar herniation consistent with mild Chiari malformation. Mild hydrocephalus was also noted th...

Vertebral artery aneurysms are a rare type of vasculopathy with significant risk rupture, ischemia, and potential neurological deficits. Their location in the cervical region presents surgical challenge open endovascular options alike lack consensus on best treatment option. We present an approach to vertebral aneurysm repair patient vascular Ehlers-Danlos syndrome (type IV). A 44-year-old male...

Letters to the Editor will be published, if suitable, as space permits. They should not exceed 1,000 words (typed double-spaced) in length and may be subject to editing or abridgment. To the Editor: The four-vessel occlusion method developed by Drs. Pulsi-nelli and Brierley is widely used as an experimental model for bilateral hemispheric ischemia in the field of pathophysiology. 1-2 However, t...

BACKGROUND AND PURPOSE Injury to spinal segmental arteries may potentially occur during spinal surgery, particularly during anterior or minimally invasive approaches. Use of a noninvasive radiologic tool to evaluate these arteries before surgery may reduce this risk. MATERIAL AND METHODS We performed spinal CT angiography and reconstructed 3D images of segmental arteries in 41 patients. We cl...

OBJECTIVE The purposes of this study were to assess prospectively the frequency of vertebral artery injuries after major acute cervical spine trauma as determined by MR angiography and to assess the clinical consequences of these injuries. SUBJECTS AND METHODS During a 6-month period, 37 patients who had major acute nonpenetrating cervical spine trauma were examined with MR imaging, usually w...

Cervical manipulation occasionally causes serious vertebrobasilar complications. The usual cause is vertebral artery dissection, however in some cases there has been no obvious arterial injury. The present paper reviews the mechanisms by which complications occur, particularly when the applied force is trivial or there is no injury to the vertebral arteries, and the factors that increase risk o...

PURPOSE To determine the cause of right to left signal intensity differences arising from intracranial vessels during routine spin-echo axial MR imaging of the head. METHODS AND RESULTS Using a normal imaging sequence in which the default directions of the frequency and phase axes were horizontal and vertical, respectively, differences in signal intensity arising from the vertebral arteries w...

Using directional continuous-wave Doppler sonography of the vertebral arteries, we have investigated 1,540 patients during the past 5 years. On the basis of unilateral and bilateral retrograde brachial angiograms in the same patients (a total of 1,989 angiograms) we have developed sonographic criteria for demonstrating a significant increase in the peripheral resistance of both distal vertebral...

A prospective blind comparison was completed between duplex sonography and angiography of the vertebral arteries. Thirty-two vertebral arteries were studied for direction of flow, degree of origin plaque or stenosis, Doppler characteristics, and vessel size. The vertebral arteries were reliably identified by imaging their course from the subclavian artery into the transverse foramina and by ide...

We recently read the interesting article by Albayram et al (1), which concisely explained the anomalies of the vertebral arteries. We would like to present another rare case of bilateral vertebral arteries originating from the aortic arch. We incidentally diagnosed this condition on the basis of findings on a chest CT scan obtained in a patient with trauma. Our trauma chest CT protocol uses 8 2...