Variable anatomic configuration of the posterior spinal arteries in humans

Rojas, Santiago; Ortega, M.; Rodríguez‐Baeza, Alfonso

doi:10.1002/ca.23213

Cited by 12 publications

(6 citation statements)

References 38 publications

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“…Based on the current study, we propose a classification scheme of the collaterals that constitute the vasocorona. Previous work that has investigated vascularization of the spinal cord has focused on the origin of spinal arteries and distribution of segmental medullary arteries, with special attention paid to the artery of Adamkiewicz and configuration of the anastomotic circle of the conus medullaris (Adamkiewicz, 1882; Bosmia, Hogan, Loukas, Tubbs, & Cohen‐Gadol, 2015; Kadyi, 1889; Rodriguez‐Baeza, Muset‐Lara, Rodriguez‐Pazos, & Domenech‐Mateu, 1991; Rodríguez‐Baeza, Muset‐Lara, Rodríguez‐Pazos, & Domenech‐Mateu, 1989; Rojas, Ortega, & Rodríguez‐Baeza, 2018b). Conversely, collaterals of the anterior and posterior anastomotic pathways have attracted little attention.…”

Section: Resultsmentioning

confidence: 99%

Anatomical study of the pial arterial network in human spinal cords

2020

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Introduction Multiple collaterals originate from three main longitudinal vessels to perfuse the human spinal cord. Only a few classic studies published in the last century have investigated these collaterals. The current work proposes a possible classification of these vessels and analyzes their relative abundance along spinal cord segments. Materials and Methods Human spinal cords (n = 30) from male and female cadavers were injected with colored latex through the vertebral, ascending cervical, costocervical trunk and segmental arteries and then fixed in formaldehyde solution. Afterwards, spinal vessels were dissected and the relative abundances of each type of collateral were quantified and compared between different spinal cord segments. Results Collaterals of the anterior longitudinal pathway can be classified as central arteries and arteries for the anterior and lateral columns. Collaterals for the anterior column can be classified into two types: anteromedial and anterolateral. Arteries for the lateral column can be classified, according to their relationship with the dentate ligament, as either preligamentous or post‐ligamentous. The collaterals of posterior longitudinal pathways can be divided between those for the posterior and those for the lateral column. In turn, the arteries for the posterior column can be classified into three types: median posterior, posteromedial and posterolateral. The collaterals for the lateral column were also classified as either pre‐ or post‐ligamentous. Conclusion The relative abundance of the various types of collateral and anastomoses between longitudinal pathways was inhomogeneous along the spinal cord, with several statistically significant differences observed between spinal segments.

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Section: Resultsmentioning

confidence: 99%

Anatomical study of the pial arterial network in human spinal cords

2020

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“…Interrupted blood ow through the PSAs should result in ischemia of the dorsally-placed tracts of the cord, leading to sensorimotor impairments re ective of dysfunction involving the posterior columns, posterior horns, and the posterior parts of the lateral columns. However, the arterial boundaries between the PSAs and ASAs are indistinct and ambiguous, and may explain the frequent occurrence of ipsilateral weakness re ecting concomitant involvement of the more anteriorly-placed pyramidal tracts [4,10,37]. The resultant variations in the clinical features can thus present physicians with signi cant diagnostic challenges.…”

Section: Discussionmentioning

confidence: 99%

Clinical Features and Outcomes of Posterior Spinal Artery Infarction: A Systematic Review

Tan,

Teo,

Yeo

et al. 2023

Preprint

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Objective We aim to describe the clinical features and outcomes of patients with posterior spinal artery infarctions, and to identify factors associated with poor ambulatory outcomes. Methods We performed a systematic review and retrospective analysis on the characteristics and outcomes of patients with posterior spinal artery infarctions reported over the past 30 years. Results We analyzed 40 cases from 33 studies between January 1993 till June 2023. Their median age was 55 years (range 19–84), with 23 males and 17 females. Cardiovascular risk factors were present in half (21/40, 53%). Pain (10/40, 48%) and motor deficits (27/39, 69%) were common Infarcts preferentially affected the cervical cord (29/40, 73%), and were frequently attributed to vertebral artery dissections (8/40, 20%) endovascular treatment complications (7/40, 18%)., However, the underlying cause remained unknown in a quarter (10/40, 25%). Treatment involved isolated or concomitant use of anticoagulants (8/28, 29%), antiplatelet (18/28, 64%), and steroids (5/28, 18%). Prognosis appeared fair as most could ambulate (28/34, 82%), but over a quarter could only do so with assistance (8/28, 29%). Patients who were older, (median age [range]: 67 [52–84] vs 56 [28–79], p = 0.055), with preceding trauma (50% vs 11%, p = 0.053), or with infarcts involving three or more cord segments (83 vs 33%, p = 0.062) may be likelier to experience non-ambulatory outcomes. Conclusion Though rare, posterior spinal artery infarctions’ propensity for disability renders their early recognition especially vital. Pain and preceding trauma or endovascular treatment are diagnostic clues. Old age, preceding trauma, and longer infarcts may be associated with non-ambulatory outcomes.

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“…As ischemic complications with parent artery occlusion are reported to be 17-40% [4], parent artery occlusion for the DPICAAn seems unsuitable for cases in which sacrifice of the single-dominant PICA such as in our case, can result in fatal cerebellar edema. Parent artery occlusion of the PICA can result in spinal cord ischemia as the posterior spinal arteries originate from PICA in 20-50% of cases [20].…”

Section: Discussionmentioning

confidence: 99%

Distal posterior inferior cerebellar artery aneurysm with cerebellar arteriovenous malformation treated by open surgery: a case report

et al. 2019

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Background: The detection of a feeder aneurysm and an arteriovenous malformation (AVM) is relatively rare for the intracranial AVM. The distal posterior inferior cerebellar artery aneurysm (DPICAAn) is reported to coexist or relate with the cerebellar AVM. In previous reports about the treatment of a DPICAAn and a cerebellar AVM, endovascular embolization with the sacrifice of the posterior inferior cerebellar artery (PICA) has often been selected. However, there have been few reports of simultaneous open surgery for coexistent cases of DPICAAn and cerebellar AVM. Case description: A 67-year-old male presented with a headache. We detected a right DPICAAn in the telovelotonsillar segment and a cerebellar AVM primarily fed by the left superior cerebellar artery (SCA). In addition, the nidus was located medially in the left upper cerebellar hemisphere. Magnetic resonance imaging raised suspicions of asymptomatic past hemorrhage in the cerebellar AVM. The left PICA was agenesis, and the right PICA perfused the bilateral inferior cerebellar hemispheres; thus, the right PICA could not be sacrificed. We selected open surgery to prevent any hemorrhagic event from the DPICAAn and the cerebellar AVM. The cerebellar AVM was completely removed, and the DPICAAn was successfully clipped in a single-session open surgery. Conclusions: Open surgery can be considered for DPICAAn and cerebellar AVM. The anatomical location of the DPICAAn and AVM contributed to the success of a single-session open surgery.

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Variable anatomic configuration of the posterior spinal arteries in humans

Cited by 12 publications

References 38 publications

Anatomical study of the pial arterial network in human spinal cords

Anatomical study of the pial arterial network in human spinal cords

Clinical Features and Outcomes of Posterior Spinal Artery Infarction: A Systematic Review

Distal posterior inferior cerebellar artery aneurysm with cerebellar arteriovenous malformation treated by open surgery: a case report

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