ANATOMICAL VARIATIONS OF THE VERTEBRAL ARTERY AND THEIR IMPLICATIONS

Authors

DOI:

https://doi.org/10.32435/envsmoke-2024-0005

Keywords:

Vertebral Arteries, Stroke, Resistance Index

Abstract

The Vertebral arteries correspond to a pair of vessels that originate from the superior branch of the 1st portion of the A. Subclavia. In general, they present general anatomical variations regarding the length and diameter of the lumen, with the left being larger than the right. More extreme variations, such as the absence of one of the arteries, due to agenesis or involution, are generally related to craniovertebral defects. The objective of this work was to evaluate the anatomical variations found in the vertebral arteries and to discuss their clinical implications. In the construction of this study, a descriptive research, of the RIL type, was carried out, fulfilling all the stages of development. The search resulted in 23 articles. After reading, the corpus was composed of 12 articles, whose potential content was dedicated to investigating the type of anatomical variation of the vertebral artery and its implications and harms in the health of the carriers. Symmetrical vertebral arteries are found in about 26% of individuals. Marked differences in the diameter of the arteries, called Vertebral Artery Dominance (VAD) result in a significant decrease in the blood flow velocity of the artery and an increase in the resistance index (RI). The incidence of infarction in the posterior region of the brain is significantly higher in individuals with VAD. Infarctions occurred more frequently on the side of the non-dominant vertebral artery, probably due to non-mixing of Aa blood. vertebral arteries within the A. basilar, which run separately and with a central zone where flow is absent, called the "dead spot". Changes in normal blood flow were tested to determine their correlations with sites of thrombosis and atherosclerosis in humans. The agenesis of some branches of A. vertebral is also identified as an important factor for the occurrence of strokes in the posterior region of the brain.

Downloads

Download data is not yet available.

Author Biographies

Gil Dutra Furtado, Centro Universitário Maurício de Nassau - UNINASSAU, João Pessoa, Paraíba, Brasil

Pós-Doutor em Manejo e Conservação do Meio Ambiente (UFPB); Doutor em Psicobiologia (UFRN); Médico Veterinário (UNINASSAU/PB); Engenheiro Agrônomo (UFPB); Psicopedagogo (UNINTER/PR), João Pessoa, Paraíba, Brasil.

Marcos Antônio Jerônimo Costa, Universidade Estadual da Paraíba (UEPB), João Pessoa, Paraíba, Brasil

Professor Doutor da Universidade Estadual da Paraíba (UEPB), João Pessoa, Paraíba, Brasil.

Sérgio Eduardo Jerônimo Costa, Universidade Federal da Paraíba (UFPB), Pós-graduação em Enfermagem (PPGENF), Departamento de Enfermagem, João Pessoa, Paraíba, Brasil

Mestre em Enfermagem pelo Programa de Pós-graduação em Enfermagem (PPGENF-UFPB), João Pessoa, Paraíba, Brasil.

Felipe Eduardo da Silva Sobral, Centro Universitário Maurício de Nassau - UNINASSAU, João Pessoa, Paraíba, Brasil

4Professor Mestre da Faculdade Mauricio de Nassau (UNINASSAU).

Catarina Maria Andrade Figueiredo Guimarães Maia, União das Instituições Educacionais de São Paulo (UNIESP), São Paulo, São Paulo, Brasil

Doutora em Terapia Intensiva do Instituto SOBRATI. Docente do Centro Universitário (UNIESP), São Paulo, São Paulo, Brasil.

Janyeliton Alencar de Oliveira, Universidade Federal da Paraíba (UFPB), João Pessoa, Paraíba, Brasil

Mestre em Educação Física pelo Programa Associado de Pós-graduação em Educação Física (PAPGEF – UPE/UFPB), João Pessoa, Paraíba, Brasil.

References

AKGUN, V., BATTAL, B., BOZKURT, Y., OZ, O., HAMCAN, S., SARI, S., AKGUN, H. Normal anatomical features and variations of the vertebrobasilar circulation and its branches: An analysis with 64-detector row CT and 3T MR angiographies. The Scientific World Journal, 29 Apr. 2013. Available from: https://doi.org/10.1155/2013/620162

BERGMAN, E. M., PRINCE, K. J. A. H., DRUKKER, J., VAN DER VLEUTEN, C. P.M., SCHERPBIER, A. J. How much anatomy is enough? Anatomy Sciemces Education, v. 1, p. 4, p. 184-188, 2008. Available from: https://doi: 10.1002/ase.35

BERNARDO, W. M., NOBRE, M. R. C., JATENE, F. B. Evidence based clinical practice. Part II - searching evidence databases. Rev Bras Reumatol, v. 50, n. 1, 2004. Available from: https://doi: 10.1590/s010442302004000100045

BLACKBURN, K., LABRANCHE, L., KALMEY, J., KULESZA, R. A case of a single intracranial vertebral artery and cerebral infarct. Morphologica, Poland, v. 76, n. 1, 2017. Available from: https://doi.org/10.5603/FM.a2016.0033

CHONG, B. W., KERBER, C. W., BUXTON, R. B., FRANK, L. R., HESSELINK, J. R. Blood flow dynamics in the vertebrobasilar system: Correlation of a transparent elastic model and MR angiography. American Journal of Neuroradiology, v. 15, p. 4, 1994. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8334205/.

HONG, J. M., CHUNG, C. S., BANG, O. Y., YONG, S. W., JOO, I. S., HUH, K. Vertebral artery dominance contributes to basilar artery curvature and peri-vertebrobasilar junctional infarcts Journal Neurology Neurosurgery Psychiatry, v. 80, n. 10, 2009. Available from: https://doi.org/10.1136/jnnp.2008.169805

JENG, J. S., YIP, P. A. K. Evaluation of vertebral artery hypoplasia and asymmetry by colorcoded duplex ultrasonography. Ultrasound Med Biology. v. 30, n. 5, 2004. Available from: https://doi: 10.1016/j.ultrasmedbio.2004.03.004

KIM, Y. D., YEO, H. T., CHO, Y. D. Anomalous variations of the origin and course of vertebral arteries in patients with retroesophageal right subclavian artery. Journal of Korean Neurosurgical Society, v. 45, n. 5, p. 297-299, 2009. Available from: https://doi.org/10.3340/jkns.2009.45.5.297

KOMIYAMA, M., ISHIGURO, T., MORIKAWA, T., NISHIKAWA, M., & YASUI, T. Distal stump of an occluded intracranial vertebral artery at the vertebrobasilar junction mimicking a basilar artery aneurysm. Acta Neurochirurgica, v. 143, n. 10, p. 1013-1017, 2001. Available from: https://doi.org/10.1007/s007010170006

NERI, G., PIGNATELLI, G. R. F., PACELLA, A., ORTORE, R., KHASAWNEH, L. Recurring paroxysmal positional vertigo: Evaluation of the vascular factor. Acta Otorhinolaryngologica Italica, v. 41, n. 1, 2021. Available from: https://doi.org/10.14639/0392-100X-N0502

PERREN, F., POGLIA, D., LANDIS, T., SZTAJZEL, R. Vertebral artery hypoplasia: A predisposing for posterior circulation stroke? Neurology, v. 68, n. 1. 2007. Available from: https://doi.org/10.1212/01.wnl.0000250258.76706.98

SEIDEL, E., EICKE, B. M., TETTENBORN, B., & KRUMMENAUER, F. Reference values for vertebral artery flow volume by duplex sonography in young and elderly adults. Stroke, v. 30, n. 12, 1999. Available from: https://doi.org/10.1161/01.STR.30.12.2692

SHOJA, M. M., TUBBS, R. S., KHAKI, A. A., SHOKOUHI, G., FARAHANI, R. M., & MOEIN, A. A rare variation of the vertebral artery. Folia Morphologica, v. 65, n. 2, p. 167-170, 2006. Available from: https://journals.viamedica.pl/folia_morphologica/article/viewFile/16107/12745.

SIKKA, A., JAIN, A. Bilateral Variation in the Origin and Course of the Vertebral Artery. Anatomy Research International, 2012. Available from: https://doi.org/10.1155/2012/580765

SMITH, A. S., BELLON, J. R. Parallel and spiral flow patterns of vertebral artery contributions to the basilar artery. American Journal of Neuroradiology, v. 16, n. 8, 1995. Available from: https://www.ajnr.org/content/ajnr/16/8/1587.full.pdf.

ŠUTALO, I. D., BUI, A. V., AHMED, S., LIFFMAN, K., MANASSEH, R. Modeling of flow through the circle of willis and cerebral vasculature to assess the effects of changes in the peripheral small cerebral vasculature on the inflows. Engineering Applications of Computational Fluid Mechanics, v. 8, n. 4, p; 609-622, 2014. https://doi.org/10.1080/19942060.2014.11083311

TETIKER, H., ÇIMEN, M., KOSAR, M. I. Evaluation of the Vertebral Artery by 3D Digital Subtraction Angiography. International Journal of Morphology, v. 32, n. 3, 2014. Available from: https://doi.org/10.4067/s0717-95022014000300010

WANG, S., WANG, C., LIU, Y., YAN, M., ZHOU, H. Anomalous vertebral artery in craniovertebral junction with occipitalization of the atlas. Spine, v. 34, n. 26, p. 2838-2842, 2009. Available from: https://doi.org/10.1097/BRS.0b013e3181b4fb8b

WHITTEMORE, R. Combining evidence in nursing research: Methods and implications. Nursing Research, v. 54, n. 1, p. 56-62, 2005. Available from: http://doi.org/10.1097/00006199-200501000-00008

WORLD HEALTH ORGANIZATION. Infection prevention and control during health care when novel coronavirus (nCoV) infection is suspected, interim guidance, IRIS, v. 1, 2019. Available from: https://apps.who.int/iris/handle/10665/174652, Accessed 17 Jan. 2023.

YAPRAK, F., OZER, M. A., GOVSA, F., ERASLAN, C. Variations of the extracranial segment of vertebral artery as a bleeding risk factor. Surgical and Radiologic Anatomy, v. 43, n. 10, p. 1735-1743, 2021. Available from: https://doi.org/10.1007/s00276-021-02748-z

ZHANG, D. P., ZHANG, S. L., ZHANG, J. W., ZHANG, H. T., FU, S. Q., YU, M., REN, Y. F., JI, P. Basilar artery bending length, vascular risk factors, and pontine infarction. Journal of the Neurological Sciences, v. 338, n. 1–2, p. 142-147, 2014. Available from: https://doi.org/10.1016/j.jns.2013.12.037

ZHU, W., WANG, Y. fANG, DONG, X. fENG, FENG, H. XUAN, ZHAO, H. qING, LIU, C. fENG. Study on the correlation of vertebral artery dominance, basilar artery curvature and posterior circulation infarction. Acta Neurologica Belgica, v. 116, n. 3, p. 287-293, 2016. Available from: https://doi.org/10.1007/s13760-0150570-5

Downloads

Published

2024-04-11

How to Cite

Dutra Furtado, G., Antônio Jerônimo Costa, M., Eduardo Jerônimo Costa, S., Eduardo da Silva Sobral, F., Maria Andrade Figueiredo Guimarães Maia, C., & Alencar de Oliveira, J. (2024). ANATOMICAL VARIATIONS OF THE VERTEBRAL ARTERY AND THEIR IMPLICATIONS. Environmental Smoke, 7, 01–06. https://doi.org/10.32435/envsmoke-2024-0005

Issue

Section

Full Articles

Most read articles by the same author(s)