Okajimas Folia Anat. Jpn., 75(5): 259-262, December, 1998

An Anomalous Ascending Cervical Artery

By

A.H. OZTURK, A. BAYRAMOGLU, H.H. CELIK and N. YENER

Department of Anatomy, Hacettepe University, Faculty of Medicine, 06100 Ankara, Turkey

-Received for Publication, October 1, 1998-

Key Words: Variation, Ascending cervical artery

Summary: During gross anatomy dissection of the neck region, an anatomical variation of the ascending cervical artery was detected. Normally this artery is a branch of the inferior thyroid artery, which is a branch of the thyrocervical trunk. In our case, we found that the ascending cervical artery emerged from the superficial cervical artery, nearly 1 cm. lateral to the origin of this artery from the thyrocervical trunk.

In most cases, ascending cervical artery is a Case Report branch of the inferior thyroid artery originating from the thyrocervical trunk. The thyrocervical During gross anatomy dissection of the neck trunk emerges from the first part of the subclavian region of a 37 year old male cadaver, we observed artery close to the medial border of the scalenus an abnormal origin of the ascending cervical artery. anterior muscle. Then it divides into three In some cases the superficial cervical and dorsal branches, namely, inferior thyroid, superficial cer- scapular arteries have a common origin from the vical and suprascapular arteries. thyrocervical trunk, named as the transverse cer- The inferior thyroid artery ascends in front of vical artery, which then divides into two branches. the medial border of the scalenus anterior muscle. In our case we observed that dorsal scapular artery It then passes medially between the carotid sheath was originating from the third part of the sub- and the vertebral artery. Finally it descends on the clavian artery and there was only superficial cer- longus colli muscle to reach the inferior part of the vical artery which was originating from the thyro- thyroid gland. In this region inferior thyroid artery cervical trunk. gives many branches such as; muscular branches, ascending cervical artery, inferior laryngeal artery, pharyngeal, tracheal, eusophagial and large glan- Discussion dular branches8). In most cases ascending cervical artery arises Ascending cervical artery, which arose from the from the upper part of the inferior thyroid artery superficial cervical artery in our case, should still and it runs upwards on the anterior tubercles of the has an important contribution to the arterial supply transverse processes of the cervical vertebrae be- of the spinal cord at the cervical level. Animal tween the scalenus anterior and longus capitis experiments show that, by arresting the blood flow muscle. It gives branches to the longus colli, scale- in a segment of the cord for only 2-3 minutes, the nus anterior and it has an important contribution to delicate neural structures can not survive under the arterial supply of the spinal cord in the cervical conditions of anoxemia2). In addition a postmortem region7). It may also arise directly from the thyro- angiographic study shows that impaired blood flow cervical trunk°. of the arteries supplying the cervicobrachial area might play a role in cervico brachial disorders3). An other study points out that a collateral circle between vertebral artery and the cervical branches,

For correspondence please address to: Alp Bayramoglu, M.D., Ph.D., Department of Anatomy, Hacettepe University, Faculty of Medicine, 06100 Ankara, Turkey.

259 260 A.H. OztUrk et al. arising from the thyrocervical and costocervical References trunks is important to maintain perfusion in verte- bral artery obstructions4). So during any surgical 1) Chakravorty BG. Arterial supply of the cervical spinal cord approach to the region one should consider the (with special reference to the radicular arteries). Anat Rec 1970; 170:311-330. arterial variations to avoid such complications. 2) DommisseFG. The arteries, arterioles, and capillaries of the Cervical radicular arteries may originate from spinal cord. Annals of the Royal College of Surgeons of subclavian branches other than vertebral, and England 1980;62:369-376. among these ascending cervical branch of thyro- 3) Kauppila LI and Penttila A. Postmortem angiographicstudy cervical trunk is the most important. of degenerative vascular changes in arteries supplying the cervicobrachialregion. Ann Rheum Dis 1994;53(2):94-99. A terminal zone probably exists at highest 4) Macchi C and Catini C. The anatomy and clinical im- thoracic segments where craniocervical, and thora- portance of the collateral circles between the vertebral ar- cic radicular flows meet. The filling of the anterior teries and the cervical, costo-cervical,and occipital branches spinal trunk in the cervical region depends on the in 52 living subjects. Ital J Anat Embryol 1993; 98(3):153— availability of at least one major anterior radicular 163. 5) Tveten L. Spinal cord vascularity. I. Extraspinal sources of artery. Interruption of radicular supply may be pre- spinal cord arteries in man. Acta Radiol (Diagn) 1976; cipitated by trauma, spondylosis and other lesions 1F(1):1-16. resulting into ischemia, and myelopathy; the risk is 6) Cordier G and Delmes A. Anatomic Humaine. Masson ET. greater if there is only one radicular artery which is C're, Paris 1962. involved')• 7) Berkovitz BKB and Moxham BJ. Head and Neck Anatomy. Wolfe Medical Publications, London 1988. Because of the contributions to the blood supply 8) WilliamsPL, Bannister LH, Berry MM, CollinsP, Dyson M, of the spinal cord, arterial variations in this region Dussek JE and Ferguson MWJ. Gray's Anatomy, 38thedi- may alter the susceptability of a person to ischemic tion. Churchill Livingstone,New York 1995;pp. 1535. injuries. Although there are many anastomoses between the arteries supplying the spinal cord, any arterial variation in the region may more or less affect the degree of susceptibility to an ischemic injury. An Anomalous Ascending Cervical Artery 261 Plate I

Explanation of Figure

Plate I