Anatomical Features and Clinical Significance of Radiculomuscular Artery Variants Involving the Suboccipital Segment of Vertebral Artery : Angiographic and Cadaver Studies.
OBJECTIVE
To discuss the significance of the radiculomuscular artery in typical variations of the distal vertebral artery (VA) from the viewpoint of microsurgical anatomy.


METHODS
Some variations involving the radiculomuscular artery revealed by digital subtraction angiography (DSA) were recruited and studied together with our findings from cadaver dissections.


RESULTS
A total of 29 variants were found in 26 patients, including 10 C‑2 vertebral origins of the posteroinferior cerebellar artery (PICA), 13 duplicated (12 patients) and 6 aberrant V3s. An aberrant V3 was observed in our cadaver specimen. Each of these variants involved only the distal part of the lateral spinal artery (LSA) that incorporates the radiculomuscular artery and the radiculomedullary branch. Using DSA two aberrant V3s were indicated and another one was verified by anatomical study as an extradural location.


CONCLUSIONS
The radiculomuscular artery accounts for the C‑2 vertebral origin of the PICA, duplicated and aberrant V3, and extradural course of an aberrant V3 does exist. A probable extradural course of a variant between C‑2 and C‑1 should be kept in mind whenever each of the variations involving the radiculomuscular artery is detected by DSA or computed tomography angiography (CTA).
Department of Neurology, Qilu Hospital of Shandong University, 250012, Jinan, P.R. China.
Shao-Wei
SW
Zhu
Department of Neurosurgery, Qilu Hospital and Brain Science Research Institute of Shandong University, 250012, Jinan, P.R. China.
Yang
Y
Yang
Department of Neurosurgery, Qilu Hospital and Brain Science Research Institute of Shandong University, 250012, Jinan, P.R. China.
Yu-Guang
YG
Liu
Department of Neurosurgery, Qilu Hospital and Brain Science Research Institute of Shandong University, 250012, Jinan, P.R. China.
Jing-Wei
JW
Cao
Department of Neurosurgery, Qilu Hospital and Brain Science Research Institute of Shandong University, 250012, Jinan, P.R. China. feng.li@hotmail.com.
Feng
F
Li
D015901:Angiography, Digital Subtraction; D002102:Cadaver; D002531:Cerebellum; D002681:China; D006801:Humans; D012189:Retrospective Studies; D014711:Vertebral Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging
Computed tomography; Digital subtraction angiography; Microsurgery; Posterior inferior cerebellar artery; Retrospective study