Arterial variations around the atlas: a comprehensive review for avoiding neurosurgical complications

Abstract

Introduction: 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.

Keywords: Arterial variations; Atlas; Fenestration; Persistent intersegmental artery; Posterior inferior cerebellar artery; Proatlantal artery; Vertebral artery.