J Cerebrovasc Endovasc Neurosurg.  2018 Dec;20(4):231-234. 10.7461/jcen.2018.20.4.231.

A Type 1 Persistent Proatlantal Artery Originating from the External Carotid Artery Detected by Computed Tomographic Angiography

• Choi Y
• Chung SB
• Kim MS

• KMID: 2461921
• DOI: http://doi.org/10.7461/jcen.2018.20.4.231

Abstract

A persistent proatlantal artery (PA) is rare. We report a type 1 persistent PA originating from the right external carotid artery (ECA). A 78-year-old woman presented with dizziness. Computed tomographic (CT) angiography showed a persistent PA originating from the right ECA. This persistent PA did not pass through the atlas transverse foramen. The extracranial segment of this artery in the atlas transverse process level had a more lateral position than a normal left vertebral artery. CT angiography well demonstrated the relationship with bony structures and the course of this persistent PA. This anomalous artery in our patient presented as an incidental finding. Surgeon should recognize a persistent PA when performing carotid endarterectomy or ligation of the ECA for avoidance of complication.

Keyword

Persistent proatlantal artery; Clinical significance; Embryogenesis

MeSH Terms

Aged
Angiography*
Arteries*
Carotid Artery, External*
Dizziness
Embryonic Development
Endarterectomy, Carotid
Female
Humans
Incidental Findings
Ligation
Pregnancy
Vertebral Artery

Figure

• 

  Fig. 1 Computed tomography (CT) angiography (A, B) demonstrates a right persistent proatlantal artery originating from the right external carotid artery. This anomalous artery courses between the occiput and atlas but does not pass through the atlas transverse foramen (white dotted arrow, occipital artery; yellow arrow, proatlantal artery; blue arrow, external carotid artery; red arrow, common carotid artery; white arrow, internal carotid artery). Reconstructed CT angiography (C) shows the more lateral location of the right vertebral artery extracranial segment (white arrow) compared with the normal left vertebral artery (red arrow).

• 

  Fig. 2 Axial computed tomography images at the level of the first (A) and fourth (B) vertebral bodies show absence of a right vertebral artery in the right transverse foramen (white arrow) but an intact left vertebral artery in the left transverse foramen (black arrow).

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