title: Arterial variations around the atlas: a comprehensive review for avoiding neurosurgical complications.
abstract: BACKGROUND
  Neurosurgical approaches often involve the atlas. Therefore, the arterial relationships and anatomical variations are of paramount importance to the neurosurgeon.
  
  
  METHODS
  Using standard search engines, a literature review of arterial variants near the first cervical vertebra was performed.
  
  
  CONCLUSIONS
  Arterial variations around the atlas are surgically significant. Awareness of their existence and course may provide better pre-operative planning and surgical intervention, potentially leading to better clinical outcomes. Three-dimensional computed tomography angiography (3D CTA) is an important tool for identifying and diagnosing such abnormalities and should be used when such vascular anomalies are suspected.
authors.affiliation: St. George's University, St. George's, Grenada.
authors.forename: Galyna
authors.initials: G
authors.lastname: Ivashchuk
authors.affiliation: Saarland University Faculty of Medicine and Saarland University Medical Center, Homburg, Germany.
authors.forename: Fabian N
authors.initials: FN
authors.lastname: Fries
authors.affiliation: St. George's University, St. George's, Grenada.
authors.forename: Marios
authors.initials: M
authors.lastname: Loukas
authors.affiliation: Swedish Neuroscience Institute, Seattle, WA, USA.
authors.forename: David
authors.initials: D
authors.lastname: Paulson
authors.affiliation: Swedish Neuroscience Institute, Seattle, WA, USA.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Monteith
authors.affiliation: Swedish Neuroscience Institute, Seattle, WA, USA.
authors.forename: Jens R
authors.initials: JR
authors.lastname: Chapman
authors.affiliation: Swedish Neuroscience Institute, Seattle, WA, USA.
authors.forename: Rod J
authors.initials: RJ
authors.lastname: Oskouian
authors.affiliation: St. George's University, St. George's, Grenada. Shane.tubbs@childrensal.org.|Seattle Science Foundation, Seattle, WA, USA. Shane.tubbs@childrensal.org.
authors.forename: R Shane
authors.initials: RS
authors.lastname: Tubbs
mesh_terms: D001270:Cervical Atlas / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000517:prevention & control*; D014057:Tomography, X-Ray Computed; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000601:surgery
keywords: Arterial variations; Atlas; Fenestration; Persistent intersegmental artery; Posterior inferior cerebellar artery; Proatlantal artery; Vertebral artery