Comparison of left and right vertebral artery intracranial diameters

Mitchell, Jeanette; McKay, Alison

doi:10.1002/ar.1092420308

Cited by 23 publications

(6 citation statements)

References 37 publications

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“…This asymmetry reflected in volume of blood flow has been related to origin of left subclavian artery directly from the aorta and angle of origin of vertebral artery [ 18 ]. Mean diameter of the vertebral artery of 2.65 mm is comparable to 2.6 mm reported for a study on an English population [ 19 ] but higher than 1.73 mm reported for a South African population [ 20 ]. It is lower than 3.25 for an Iranian population [ 18 ], 3.15 mm in Indian population [ 17 ], and 3.08 mm in Turkish [ 21 ] population.…”

Section: Discussionsupporting

confidence: 57%

Vertebral Artery Hypoplasia in a Black Kenyan Population

Ogeng’o

Olabu

Sinkeet

et al. 2014

International Scholarly Research Notices

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This study examined the characteristics of vertebral artery hypoplasia in 346 arteries of adult black Kenyans. The circumference was measured on haematoxylin/eosin stained microscopic sections of the distal one-third of the intracranial vertebral arteries using scion image analyser. Internal diameter was calculated in millimetre. Data were analysed using SPSS version 16.0. Vertebral artery hypoplasia (diameter < 2.0 mm) occurred in 100 (28.9%) arteries. Sixty of these (17.3%) were on the left and 40 (11.6%) on the right. Sixty (17.3%) were in females while 40 (11.6%) were in males. The side and gender differences were statistically significant at confidence interval of 95%. Frequency of vertebral artery hypoplasia was higher than in most other populations studied. The condition differs from that in other populations because it is more common on the left side and in females. We recommend ultrasound, angio-CT, or angio-MRI evaluation of vertebral arterial system before diagnostic or interventional procedures on posterior circulation.

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Section: Discussionsupporting

confidence: 57%

Vertebral Artery Hypoplasia in a Black Kenyan Population

Ogeng’o

Olabu

Sinkeet

et al. 2014

International Scholarly Research Notices

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“…Moreover, distortion of the vertebral artery will be more severe if the vessel is larger than average, passing through a smaller retroarticular canal, as regards cross-sectional area. Although Mitchell and McKay [1995] showed that there was no statistically significant difference between the left and right vertebral artery intracranial diameters (2.0¤±¤0.6 and 2.0¤±¤0.5 mm, respectively, excluding the tunica adventitia) in the South African population, there was a significant difference in these measurements in the white females (left: 2.4¤±¤0.4 mm and right: 1.9¤±¤0.55 mm). It is not known if the extracranial diameter of the vertebral artery is similar to the intracranial diameter in the South African population, and this is being investigated in a further study by the present author.…”

Section: Measurement Of the Retroarticular Canals Of The Atlas Vertebraementioning

confidence: 78%

The Incidence and Dimensions of the Retroarticular Canal of the Atlas Vertebra

Mitchell

1998

Cells Tissues Organs

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The retroarticular canal has been implicated in compression of the vertebral artery, where it passes over the posterior arch of the atlas vertebra, during extreme rotational movements of the head and neck. The incidence of this retroarticular canal is not known in the South African population. The aim of the present study was to record the incidence and the dimensions of the retroarticular canal in South African white and black adults, aged 20–80 years. In a total of 1,354 atlas vertebrae, 9.8% of sides (264 left and/or right sides) were classified as having complete retroarticular canals, of which 11.7% (31 sides) were right-only, 24.6% (65 sides) left-only and 31.8% (84 left plus right sides) bilateral canals. This incidence did not increase with age and was lower in whites than blacks, with white males having the lowest and white and black females alike having the highest incidence of the canal. Measurements of the retroarticular canal showed that there was no difference between left and right sides. However, the superoinferior diameter was significantly less than the anteroposterior diameter, in all but the right canals in the white female subgroup. This difference in the dimensions of the retroarticular canal will decrease the cross-sectional area of the space available for the vertebral artery passing through it and may compromise blood flow in the vessel.

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“…The axial diameter of the right ALM was also greater than that of the left ALM ( P = 0.054), possibly related to the more dominant vertebral artery more frequently occurring on the left, compared with the right side. [14]…”

Section: Resultsmentioning

confidence: 99%

Atlas instrumentation guided by the medial edge of the posterior arch: An anatomic and radiologic study

Al‐Habib

Al-Rabie

Aleissa

et al. 2017

J Craniovert Jun Spine

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Study Design:This was an interventional human cadaver study and radiological study.Objectives:Atlas instrumentation is frequently involved in fusion procedures involving the craniocervical junction area. Identification of the entry point at the center of atlas lateral mass (ALM) is challenging because of its rounded posterior surface and the surrounding venous plexus. This report examines using the medial edge of atlas posterior arch (MEC1) as a fixed and reliable anatomic reference to guide the entry point of ALM screws.Methods:Fifty, normal, cervical spine computed tomography studies were reviewed. ALM screw trajectories were planned at one point along MEC1 and another point 2 mm lateral to MEC1. Free-hand ALM instrumentation was performed in ten fresh human cadavers using the 2 mm entry point, with a sagittal trajectory parallel to atlas inferior arch (IAC1); three-dimensional imaging was then performed to confirm instrumentation accuracy.Results:The average ALM diameter was 12.35 mm. Inserting a screw using the entry point 2 mm lateral to MEC1 was closer to ALM midpoint than using the entry point along MEC1 (P < 0.0001). Twenty ALM screws were successfully inserted in the ten cadavers. No encroachments into the spinal canal or foramen transversarium occurred. However, two screws were superiorly directed and violated the occipitocervical joint; they were not parallel to IAC1.Conclusion:MEC1 provides a fixed and reliable landmark for ALM instrumentation. An entry point 2 mm point lateral to MEC1 is close to ALM midpoint. IAC1 also provides a guide for the sagittal trajectory. Attention to anatomic landmarks may help reduce complications associated with atlas instrumentation but should be verified in future clinical studies.

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Comparison of left and right vertebral artery intracranial diameters

Abstract: Such a statistically significant difference implies a difference of biological importance and it is suggested that this particular group of subjects may be a high-risk group as regards vascular accidents following cervical spine manipulation.

Cited by 23 publications

References 37 publications

Vertebral Artery Hypoplasia in a Black Kenyan Population

Vertebral Artery Hypoplasia in a Black Kenyan Population

The Incidence and Dimensions of the Retroarticular Canal of the Atlas Vertebra

Atlas instrumentation guided by the medial edge of the posterior arch: An anatomic and radiologic study

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