Persistent proatlantal artery with carotid-vertebral anastomosis

Abstract

The authors describe the occurrence of proatlantal artery as an incidental angiographic observation in a young Indian soldier. This primitive anastomotic channel is seen extending from near the origin of the external carotid artery to the suboccipital region, traversing the foramen magnum and coursing beyond like a vertebral artery. The developmental and roentgenological aspects of carotid-basilar and carotid-vertebral anastomosis are discussed, along with a review of four similar cases reported previously.

Foramen magnum meningiomas: detailed surgical approaches and technical aspects at Lariboisière Hospital and review of the literature

“… The VA V3 segment can have an intradural course that corresponds to a VA duplication: One atretic portion follows the normal course, but the main portion pierces the dura between C1 and C2 [ 23 , 26 , 30 , 40 , 53 ]. A proatlantal artery consists of a persistent congenital anastomosis between the carotid artery and the VA; it is often associated with an atretic proximal VA and an extracranial origin of the PICA [ 12 , 36 , 48 ]. Finally, the groove of the arch of the atlas can be turned into a tunnel if the occipitoatlantal membrane is calcified or ossified, raising some difficulties to expose the horizontal portion at this level [ 23 , 47 ].…”

Primitive persistent carotid‐basilar and carotid‐vertebral anastomoses: A report of seven gases and a review of the literature

“…According to Kwak and Kadoya (1983), about 420 cases of primitive trigeminal artery, 160 cases of primitive hypoglossal artery, and 8 cases of primitive otic artery were reported. Cases of proatlantal intersegmental artery were also presented (Rao and Sethi, 1975;Tanaka et al, 1983).…”

“…Many clinical and autopsy studies of these anastomoses have been reported as case reports (Tanaka et al, 1983;Rao and Sethi, 1975;Lie, 1968;Shintani et al, 1990;Schuierer et al, 1990;Murayama et al, 1985) Our aim in this study is to investigate the incidence and associated anomalies of primitive persistent anastomoses in a large series by the use of cerebral angiography, an efficient method for evaluating the anatomy and pathology of vascular structures.…”

Occipito-Vertebral Anastomosis; Its Clinical Significance

“…Approximately two weeks after the surgery, his right hemiparesis improved and he was able to write small letters. Sensory impairment of the right half of the body disappeared except a b 9,10,12,14,17,19,20,22) and all of those reporters concluded that such anastomotic channels were congenital. Although the anastomotic channel was seen more frequently in the presence of obliterative lesions of subclavian, carotid, or vertebral arteries,26) 17 out of 31 cases with spontaneous anastomosis between carotid and vertebral artery were reported to have no concomitant obliter -ative lesions, which were verified angiographically.11) These findings indicate that this anastomotic channel can be seen either with or without concomitant obliterative vascular diseases.…”