Neurointervention.  2016 Mar;11(1):50-54. 10.5469/neuroint.2016.11.1.50.

Duplicated Origin of the Left Vertebral Artery: A Case Report and Embryological Review

• Jung S
• Jung C
• Bae YJ
• Choi BS
• Kim JH

• KMID: 2155720
• DOI: http://doi.org/10.5469/neuroint.2016.11.1.50

Abstract

The duplicated origin of vertebral artery (VA) is a very rare condition. It could be easily misdiagnosed as an arterial dissection on selective catheter angiography, especially in a patient with acute cerebellar infarction of unknown etiology. We report a patient with an acute cerebellar infarction and duplicated origin of the left VA, which was found during the selective catheter angiography.

Keyword

Vertebral artery; Origin; Duplication

MeSH Terms

Angiography
Catheters
Humans
Infarction
Vertebral Artery*

Figure

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  Fig. 1 Brain magnetic resonance image of the patient. Diffusion weighted image showed an acute infarction in the left upper cerebellum of superior cerebellar artery territory (A). Contrast enhanced magnetic resonance angiography did not show the duplicated origin of the left vertebral artery (B).

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  Fig. 2 Left subclavian artery angiograms, anteroposterior view (A and B), of the larteral (dominant) limb of the duplicated origin of the left vertebral artery, showing filling defect at C-5 level (white arrow). Selective angiograms, anteroposterior view (C and D), showing the medial limb of the left vertebra artery (arrowhead), which enters around the C-5 level.

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  Fig. 3 The embryonic development of vertebral artery shows the vertebral arteries developing from longitudinal anastomosis of the cervical intersegmental arteries. The fifth intersegmental artery is persistent which leads to a duplicated origin from the subclavian artery and the aortic arch. (Modified from Thomas AJ et al. 2008 [5])

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