A SYSTEMATIC STUDY of the BRAIN BASE ARTERIES in the PAMPAS FOX (Dusicyon Gymnocercus)
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Ipsilateral Subclavian Steal in Association with Aberrant Origin of the Left Vertebral Artery from the Aortic Arch
411 Ipsilateral Subclavian Steal in Association with Aberrant Origin of the Left Vertebral Artery from the Aortic Arch John Holder1 Five cases are reported of left subclavian steal syndrome associated with anomalous Eugene F. Binet2 origin of the left vertebral artery from the aortic arch. In all five instances blood flow at Bernard Thompson3 the origin of the left vertebral artery was in an antegrade direction contrary to that usually reported in this condition. The distal subclavian artery was supplied via an extensive collateral network of vessels connecting the vertebral artery to the thyro cervical trunk. If a significant stenosis or occlusion is present within the left subc lavi an artery proximal to the origin of the left vertebral artery, the direction of the bl ood fl ow within the vertebral artery will reverse toward the parent vessel (retrograde flow). This phenomenon occurs when a negative pressure gradient of 20-40 torr exists between the vertebral-basilar artery junction and th e vertebral-subc lavian artery junction [1-3]. We describe five cases of subclavian steal confirmed by angiography where a significant stenosis or occlusion of the left subclavian artery was demonstrated in association with anomalous origin of th e left vertebral artery directly from the aortic arch. In all five cases blood flow at the origin of the left vertebral artery was in an antegrade direction contrary to that more commonly reported in the subclavian steal syndrome. Materials and Methods The five patients were all 44- 58-year-old men. Three sought medical attention for symptoms specificall y related to th e left arm . -
Endovascular Treatment of Stroke Caused by Carotid Artery Dissection
brain sciences Case Report Endovascular Treatment of Stroke Caused by Carotid Artery Dissection Grzegorz Meder 1,* , Milena Swito´ ´nska 2,3 , Piotr Płeszka 2, Violetta Palacz-Duda 2, Dorota Dzianott-Pabijan 4 and Paweł Sokal 3 1 Department of Interventional Radiology, Jan Biziel University Hospital No. 2, Ujejskiego 75 Street, 85-168 Bydgoszcz, Poland 2 Stroke Intervention Centre, Department of Neurosurgery and Neurology, Jan Biziel University Hospital No. 2, Ujejskiego 75 Street, 85-168 Bydgoszcz, Poland; [email protected] (M.S.);´ [email protected] (P.P.); [email protected] (V.P.-D.) 3 Department of Neurosurgery and Neurology, Faculty of Health Sciences, Nicolaus Copernicus University in Toru´n,Ludwik Rydygier Collegium Medicum, Ujejskiego 75 Street, 85-168 Bydgoszcz, Poland; [email protected] 4 Neurological Rehabilitation Ward Kuyavian-Pomeranian Pulmonology Centre, Meysnera 9 Street, 85-472 Bydgoszcz, Poland; [email protected] * Correspondence: [email protected]; Tel.: +48-52-3655-143; Fax: +48-52-3655-364 Received: 23 September 2020; Accepted: 27 October 2020; Published: 30 October 2020 Abstract: Ischemic stroke due to large vessel occlusion (LVO) is a devastating condition. Most LVOs are embolic in nature. Arterial dissection is responsible for only a small proportion of LVOs, is specific in nature and poses some challenges in treatment. We describe 3 cases where patients with stroke caused by carotid artery dissection were treated with mechanical thrombectomy and extensive stenting with good outcome. We believe that mechanical thrombectomy and stenting is a treatment of choice in these cases. Keywords: stroke; artery dissection; endovascular treatment; stenting; mechanical thrombectomy 1. -
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ONLINE FIRST This is a provisional PDF only. Copyedited and fully formatted version will be made available soon. ISSN: 0015-5659 e-ISSN: 1644-3284 Two cases of combined anatomical variations: maxillofacial trunk, vertebral, posterior communicating and anterior cerebral atresia, linguofacial and labiomental trunks Authors: M. C. Rusu, A. M. Jianu, M. D. Monea, A. C. Ilie DOI: 10.5603/FM.a2021.0007 Article type: Case report Submitted: 2020-11-28 Accepted: 2021-01-08 Published online: 2021-01-29 This article has been peer reviewed and published immediately upon acceptance. It is an open access article, which means that it can be downloaded, printed, and distributed freely, provided the work is properly cited. Articles in "Folia Morphologica" are listed in PubMed. Powered by TCPDF (www.tcpdf.org) Two cases of combined anatomical variations: maxillofacial trunk, vertebral, posterior communicating and anterior cerebral atresia, linguofacial and labiomental trunks M.C. Rusu et al., The maxillofacial trunk M.C. Rusu1, A.M. Jianu2, M.D. Monea2, A.C. Ilie3 1Division of Anatomy, Faculty of Dental Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania 2Department of Anatomy, Faculty of Medicine, “Victor Babeş” University of Medicine and Pharmacy, Timişoara, Romania 3Department of Functional Sciences, Discipline of Public Health, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania Address for correspondence: M.C. Rusu, MD, PhD (Med.), PhD (Biol.), Dr. Hab., Prof., Division of Anatomy, Faculty of Dental Medicine, “Carol Davila” University of Medicine and Pharmacy, 8 Eroilor Sanitari Blvd., RO-76241, Bucharest, Romania, , tel: +40722363705 e-mail: [email protected] ABSTRACT Background: Commonly, arterial anatomic variants are reported as single entities. -
Mechanical Thrombectomy in Basilar Artery Occlusion Presence of Bilateral Posterior Communicating Arteries Is a Predictor of Favorable Clinical Outcome
Clin Neuroradiol (2019) 29:153–160 https://doi.org/10.1007/s00062-017-0651-3 ORIGINAL ARTICLE Mechanical Thrombectomy in Basilar Artery Occlusion Presence of Bilateral Posterior Communicating Arteries is a Predictor of Favorable Clinical Outcome Volker Maus 1 ·AlevKalkan1 · Christoph Kabbasch1 · Nuran Abdullayev1 · Henning Stetefeld2 · Utako Birgit Barnikol3 · Thomas Liebig4 · Christian Dohmen2 · Gereon Rudolf Fink2,5 · Jan Borggrefe1 · Anastasios Mpotsaris6 Received: 17 August 2017 / Accepted: 21 November 2017 / Published online: 19 December 2017 © Springer-Verlag GmbH Germany, part of Springer Nature 2017 Abstract Results The favorable clinical outcome at 90 days was 25% Background Mechanical thrombectomy (MT) of basilar and mortality was 43%. The rate of successful reperfusion, artery occlusions (BAO) is a subject of debate. We inves- i.e. modified thrombolysis in cerebral infarction (mTICI) ≥ tigated the clinical outcome of MT in BAO and predictors 2b was 82%. Presence of bilateral PcoAs (area under the of a favorable outcome. curve, AUC: 0.81, odds ratio, OR: 4.2, 2.2–8.2; p < 0.0001), Material and Methods A total of 104 MTs of BAO (carried lower National Institute of Health Stroke Scale (NIHSS) out between 2010 and 2016) were analyzed. Favorable out- on admission (AUC: 0.74, OR: 2.6, 1.3–5.2; p < 0.01), PC- come as a modified Rankin scale (mRS) Ä 2at90days ASPECTS ≥ 9 (AUC: 0.72, OR: 4.2, 1.5–11.9; p < 0.01), was the primary endpoint. The influence of the follow- incomplete BAO (AUC: 0.66, OR: 2.6, 1.4–4.8; p < 0.001), ing variables on outcome was investigated: number of de- and basilar tip patency (AUC: 0.66, OR: 2.5, 1.3–4.8; p < tectable posterior communicating arteries (PcoAs), patency 0.01) were associated with a favorable outcome. -
17 Blood Supply of the Central Nervous System
17 Blood supply of the central nervous system Brain Lateral aspect of cerebral hemisphere showing blood supply Central sulcus Motor and sensory strip Visual area Broca area Circle of Willis Anterior cerebral artery Anterior communicating artery Optic chiasm IIIrd cranial nerve Middle cerebral artery IVth cranial Internal carotid artery nerve Pons Posterior communicating artery Posterior cerebral artery Auditory area and Vth cranial Wernicke's area in left nerve Superior cerebellar artery dominant hemisphere VIth cranial Pontine branches nerve Basilar artery Anterior cerebral Posterior cerebral artery supply artery supply VII and Anterior inferior cerebellar artery Middle cerebral VIII cranial artery supply nerves Vertebral artery Coronal section of brain showing blood supply IX, X, XI Anterior spinal artery cranial nerves Posterior inferior cerebellar artery XII cranial nerve Caudate Globus Cerebellum nucleus pallidus Lateral ventricle C3/C4 Branch of left Spinal cord cord thyrocervical trunk Thalamus Cervical Red nucleus Subthalamic T5/T6 Intercostal nucleus cord branch area of damage Thoracic ischaemic Watershed T10 Great-anterior L2 Anterior choroidal medullary artery artery (branch of of Adamkiewicz internal carotid cord Hippocampus Lumbar artery to lower two thirds of Reinforcing internal capsule, cord inputs globus pallidus and Penetrating branches of Blood supply to Sacral limbic system) middle cerebral artery spinal cord Posterior spinal arteries Dorsal columns Corticospinal tract supply Anterior Spinothalamic tract spinal artery Medullary artery— Anterior spinal artery replenishing anterior spinal artery directly 42 The anatomical and functional organization of the nervous system Blood supply to the brain medulla and cerebellum. Occlusion of this vessel gives rise to the The arterial blood supply to the brain comes from four vessels: the right lateral medullary syndrome of Wallenberg. -
The Variations of the Subclavian Artery and Its Branches Ahmet H
Okajimas Folia Anat. Jpn., 76(5): 255-262, December, 1999 The Variations of the Subclavian Artery and Its Branches By Ahmet H. YUCEL, Emine KIZILKANAT and CengizO. OZDEMIR Department of Anatomy, Faculty of Medicine, Cukurova University, 01330 Balcali, Adana Turkey -Received for Publication, June 19,1999- Key Words: Subclavian artery, Vertebral artery, Arterial variation Summary: This study reports important variations in branches of the subclavian artery in a singular cadaver. The origin of the left vertebral artery was from the aortic arch. On the right side, no thyrocervical trunk was found. The two branches which normally originate from the thyrocervical trunk had a different origin. The transverse cervical artery arose directly from the subclavian artery and suprascapular artery originated from the internal thoracic artery. This variation provides a short route for posterior scapular anastomoses. An awareness of this rare variation is important because this area is used for diagnostic and surgical procedures. The subclavian artery, the main artery of the The variations of the subclavian artery and its upper extremity, also gives off the branches which branches have a great importance both in blood supply the neck region. The right subclavian arises vessels surgery and in angiographic investigations. from the brachiocephalic trunk, the left from the aortic arch. Because of this, the first part of the right and left subclavian arteries differs both in the Subjects origin and length. The branches of the subclavian artery are vertebral artery, internal thoracic artery, This work is based on a dissection carried out in thyrocervical trunk, costocervical trunk and dorsal the Department of Anatomy in the Faculty of scapular artery. -
Spinal Vascular Anatomy and Pathology F O R R E S T H S U M D / M S C F O O T H I L L S M E D I C a L C E N T R E 2 2 M a R C H 2 0 0 7 Objectives
Spinal Vascular Anatomy and Pathology F o r r e s t H s u M D / M S c F o o t h i l l s M e d i c a l C e n t r e 2 2 M a r c h 2 0 0 7 Objectives Arterial supply Venous Drainage Vascular Pathology Case Presentation Blood Supply to the Spine and Spinal Cord Arterial Supply to the Spinal Cord Upper Spinal Cord C1-4 : Ant and Post spinal arteries C5-6 : Ascending vertebral artery and branches from thyrocervical trunk C7-T3: Costocervical trunk Middle Spinal Cord T4-8 : Supplied mainly by a single thoracic radicular artery @ T7 from aorta Lower Spinal Cord T9-Sacrum: Supplied mainly by a single LEFT T11 great radicular artery --> Artery of Adamkiewiz 75% from T10-12 T-L spinal also receive supply from aortic and iliac branches Lateral Sacral artery supplies sacral elements ASA ends at conus gives rise to rami cruciantes to PSA’s Arterial Supply to the Spinal Cord Anterior Anterior horns Spinothalamic Corticospinal Posterior Posterior Columns Corticospinal (variable) Vascular Watershed Areas Hypotension --> Central Grey matter ASA infarct --> Anterior 2/3 T1-4 and L4 most vulnerable to cord infarct from intercostal artery occlusion or aortic dissection Arterial Supply to the Spine Vertebral bodies and spinal cord derive blood supply from intercostal arteries that branch off the aorta. Posterior Intercostal Artery (aka Segmental artery) Dorsal Branch Spinal Branch Anterior Radicular Ant Medullary (L side) Ant Spinal Posterior Radicular Vertebral/Dural Branch 75% of blood supply to cord from Anterior spinal artery fed by 5-10 unpaired medullary arteries In T-spine = Anterior medullary artery. -
A Very Rare Origin of the Left Vertebral Artery and Its Clinical Implications
ARC Journal of Cardiology Volume 5, Issue 2, 2019, PP 14-18 ISSN No. (Online): 2455-5991 DOI: http://dx.doi.org/10.20431/2455-5991.0502003 www.arcjournals.org A Very Rare Origin of the Left Vertebral Artery and its Clinical Implications Olutayo Ariyo* Dept. of Anatomy Pathology and Cell Biology, SKMC at Thomas Jefferson University, Philadelphia, USA *Corresponding Author: Olutayo Ariyo, Dept. of Anatomy Pathology and Cell Biology, SKMC at Thomas Jefferson University, Philadelphia, USA, E-mail: [email protected] Abstract: Most variants of the left vertebral artery tend to occursupra-aortic, usually between the left common carotid and the left subclavian arteries. We report a rare variant of the left vertebral artery arising as the most distal and inferior branch off the aortic arch in a 69 year- old male cadaver. Arising postero- inferiorly from the arch, the variant coursed superiorly and medial -ward, posterior to the left subclavian artery, enteringthe transverse cervical foramina at C5 level to run more cranially cervical foramina C5-C2. The variant artery was an observed with some tortuosity just proximal to entry into C5 foramina. The normally arising left or right vertebral artery plays a vital role in the Subclavian Steal Syndrome, a retrograde flow in the ipsilateral vertebral artery in an occlusion proximal origin of its ipsilateral subclavian artery. In our reported variant, modelled with a possible occlusion in the proximal segment of the left subclavian artery, despite an hypothesized retrograde flow in the left vertebral artery will not be helpful in delivering blood into the subclavian-axillary continuum, as such retrograde flow will dump into the aortic arch directly and unhelpful to the occluded left subclavian artery. -
THE SYNDROMES of the ARTERIES of the BRAIN AND, SPINAL CORD Part II by LESLIE G
I19 Postgrad Med J: first published as 10.1136/pgmj.29.329.119 on 1 March 1953. Downloaded from - N/ THE SYNDROMES OF THE ARTERIES OF THE BRAIN AND, SPINAL CORD Part II By LESLIE G. KILOH, M.D., M.R.C.P., D.P.M. First Assistant in the Joint Department of Psychological Medicine, Royal Victoria Infirmary and University of Durham The Vertebral Artery (See also Cabot, I937; Pines and Gilensky, Each vertebral artery enters the foramen 1930.) magnum in front of the roots of the hypoglossal nerve, inclines forwards and medially to the The Posterior Inferior Cerebellar Artery anterior aspect of the medulla oblongata and unites The posterior inferior cerebellar artery arises with its fellow at the lower border of the pons to from the vertebral artery at the level of the lower form the basilar artery. border of the inferior olive and winds round the The posterior inferior cerebellar and the medulla oblongata between the roots of the hypo- Protected by copyright. anterior spinal arteries are its principal branches glossal nerve. It passes rostrally behind the root- and it sometimes gives off the posterior spinal lets of the vagus and glossopharyngeal nerves to artery. A few small branches are supplied directly the lower border of the pons, bends backwards and to the medulla oblongata. These are in line below caudally along the inferolateral boundary of the with similar branches of the anterior spinal artery fourth ventricle and finally turns laterally into the and above with the paramedian branches of the vallecula. basilar artery. Branches: From the trunk of the artery, In some cases of apparently typical throm- twigs enter the lateral aspect of the medulla bosis of the posterior inferior cerebellar artery, oblongata and supply the region bounded ventrally post-mortem examination has demonstrated oc- by the inferior olive and medially by the hypo- clusion of the entire vertebral artery (e.g., Diggle glossal nucleus-including the nucleus ambiguus, and Stcpford, 1935). -
An Unusual Origin and Course of the Thyroidea Ima Artery, with Absence of Inferior Thyroid Artery Bilaterally
Surgical and Radiologic Anatomy (2019) 41:235–237 https://doi.org/10.1007/s00276-018-2122-1 ANATOMIC VARIATIONS An unusual origin and course of the thyroidea ima artery, with absence of inferior thyroid artery bilaterally Doris George Yohannan1 · Rajeev Rajan1 · Akhil Bhuvanendran Chandran1 · Renuka Krishnapillai1 Received: 31 May 2018 / Accepted: 21 October 2018 / Published online: 25 October 2018 © Springer-Verlag France SAS, part of Springer Nature 2018 Abstract We report an unusual origin and course of the thyroidea ima artery in a male cadaver. The ima artery originated from the right subclavian artery very close to origin of the right vertebral artery. The artery coursed anteriorly between the common carotid artery medially and internal jugular vein laterally. It then coursed obliquely, from below upwards, from lateral to medial superficial to common carotid artery, to reach the inferior pole of the right lobe of thyroid and branched repeatedly to supply the anteroinferior and posteroinferior aspects of both the thyroid lobes and isthmus. The superior thyroid arteries were normal. Both the inferior thyroid arteries were absent. The unusual feature of this thyroidea ima artery is its origin from the subclavian artery close to vertebral artery origin, the location being remarkably far-off from the usual near midline position, and the oblique and relatively superficial course. This report is a caveat to neck surgeons to consider such a superficially running vessel to be a thyroidea ima artery. Keywords Thyroid vascular anatomy · Thyroidea ima artery · Artery of Neubauer · Blood supply of thyroid · Variations Introduction (1.1%), transverse scapular (1.1%), or pericardiophrenic or thyrocervical trunk [8, 10]. -
Blood Supply to the Human Spinal Cord. I. Anatomy and Hemodynamics
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by IUPUIScholarWorks Clinical Anatomy 00:00–00 (2013) REVIEW Blood Supply to the Human Spinal Cord. I. Anatomy and Hemodynamics 1 1 2 1 ANAND N. BOSMIA , ELIZABETH HOGAN , MARIOS LOUKAS , R. SHANE TUBBS , AND AARON A. COHEN-GADOL3* 1Pediatric Neurosurgery, Children’s Hospital of Alabama, Birmingham, Alabama 2Department of Anatomic Sciences, St. George’s University School of Medicine, St. George’s, Grenada 3Goodman Campbell Brain and Spine, Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana The arterial network that supplies the human spinal cord, which was once thought to be similar to that of the brain, is in fact much different and more extensive. In this article, the authors attempt to provide a comprehensive review of the literature regarding the anatomy and known hemodynamics of the blood supply to the human spinal cord. Additionally, as the medical litera- ture often fails to provide accurate terminology for the arteries that supply the cord, the authors attempt to categorize and clarify this nomenclature. A com- plete understanding of the morphology of the arterial blood supply to the human spinal cord is important to anatomists and clinicians alike. Clin. Anat. 00:000–000, 2013. VC 2013 Wiley Periodicals, Inc. Key words: spinal cord; vascular supply; anatomy; nervous system INTRODUCTION (segmental medullary) arteries and posterior radicular (segmental medullary) arteries, respectively (Thron, Gillilan (1958) stated that Adamkiewicz carried out 1988). The smaller radicular arteries branch from the and published in 1881 and 1882 the first extensive spinal branch of the segmental artery (branch) of par- study on the blood vessels of the spinal cord, and that ent arteries such as the vertebral arteries, ascending his work and a study of 29 human spinal cords by and deep cervical arteries, etc. -
The 0Ccipital-Vertebral Anastomosis
The 0ccipital-Vertebral Anastomosis MANNIE M. SCHECIITER,M.D. Section of Neuroradiology, Department of Radiology, Albert Einstein College of Medicine, New York, New York HE presence and significance of collat- artery. In the past this was, in fact, the basis eral circulation between the various for techniques of indirect vertebral angiog- T branches of the intracranial circulation raphy in which the right carotid artery was and branches of the intracranial and extra- compressed distal to the site of the puncture cranial circulation have been described in the during angiography.4,5 Similarly retrograde literature. With the current interest and em- carotid catheterization may also be used to phasis in the medical and surgical treatment demonstrate the vertebral artery and its of cerebrovascular disease and with improve- branches).1~ ments in diagnostic procedures, a clearer When filling of the vertebral artery occurs demonstration of these collateral channels is during the injection of contrast medium into now more frequently sought and recognized. the carotid artery or vice versa, the occipital- Most of these potential collateral channels vertebral anastomosis may be demonstrated become obvious only when occlusive vascular by including the cervical course of the verte- disease interrupts the normal pathways, and bral artery in the film. Absence of contrast the channels dilate to form alternate routes medium in the proximal portion of the com- for the passage of blood to vital areas. A mon carotid artery and vertebral artery will temporary differential in the hydrodynamics be recognized readily, excluding this as the of two opposing systems may also reverse the possible course of flow (Figs.