title: Anomalous course and diameter of left-sided vertebral arteries--significance and predisposing factors in clinical practice.
abstract: BACKGROUND
  The purpose of this study was to determine whether any correlation exists between the level of entry of vertebral arteries (VAs) into the foramen transversarium (FT) and their anomalous course or diameter. To our knowledge there are no studies in the literature concerning the diameter of the vertebral artery (VA) as an impact factor on entrance level.
  
  
  METHODS
  Computed tomography angiography (CTA) images of the aortic arch (AA) and its branches, obtained at the Department of Radiology, Medical University of Łódź from May 2009 to April 2012, were reviewed and the entrance points into the FT were determined.
  
  
  RESULTS
  Left vertebral arteries arising directly from the AA more often had an anomalous entrance point to the foramen transversarium and were more frequently hypoplastic. In addition, hypoplastic VAs entered the FT at an anomalous level more often than VAs with normal diameter.
  
  
  CONCLUSIONS
  The left vertebral arteries arising directly from the aortic arch are often more hypoplastic and often enter the foramen transversarium at a different level from the C6 vertebrae. In patients with hypoplastic VA detected on the basis of ultrasound Color Doppler examination, the presence of anomalies must be considered when planning surgical treatment.
authors.affiliation: Department of Radiology and Diagnostic Imaging, Medical University of Łódź, Barlicki University Hospital No.1, 90-153 Łódź, Poland. Electronic address: katarzyna_kosla@wp.pl.
authors.forename: Katarzyna Natalia
authors.initials: KN
authors.lastname: Kośla
authors.affiliation: Department of Angiology, Medical University of Łódź, 90-131 Łódź, Poland. Electronic address: mapmajos@gmail.com.
authors.forename: Marcin
authors.initials: M
authors.lastname: Majos
authors.affiliation: Department of Angiology, Medical University of Łódź, 90-131 Łódź, Poland. Electronic address: chilam@tlen.pl.
authors.forename: Michał
authors.initials: M
authors.lastname: Podgórski
authors.affiliation: Department of Angiology, Medical University of Łódź, 90-131 Łódź, Poland. Electronic address: michal.polguj@umed.lodz.pl.
authors.forename: Michał
authors.initials: M
authors.lastname: Polguj
authors.affiliation: Department of Normal and Clinical Anatomy, Medical University of Łódź, 90-131 Łódź, Poland. Electronic address: miroslaw.topol@umed.lodz.pl.
authors.forename: Mirosław
authors.initials: M
authors.lastname: Topol
authors.affiliation: Department of Radiology and Diagnostic Imaging, Medical University of Łódź, Barlicki University Hospital No.1, 90-153 Łódź, Poland. Electronic address: ludomir.stefanczyk@umed.lodz.pl.
authors.forename: Ludomir
authors.initials: L
authors.lastname: Stefańczyk
authors.affiliation: Department of Radiology and Diagnostic Imaging, Medical University of Łódź, Barlicki University Hospital No.1, 90-153 Łódź, Poland. Electronic address: agata.majos@umed.lodz.pl.
authors.forename: Agata
authors.initials: A
authors.lastname: Majos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000002:abnormalities / Q000033:anatomy & histology; D002574:Cervical Vertebrae / Q000033:anatomy & histology; D057510:Endovascular Procedures / Q000379:methods; D005260:Female; D005539:Foramen Magnum / Q000033:anatomy & histology; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014711:Vertebral Artery / Q000002:abnormalities* / Q000033:anatomy & histology*; D055815:Young Adult
keywords: Anomaly; Computed tomography angiography; Vertebral artery