Simultaneous Association of Variations in the Origin and Diameter of the Left Vertebral Artery in a Patient with a C1 Lateral Mass Tumor

Abstract

The anomalous origin of a hypoplastic Left Vertebral Artery (LVA) from the aortic arch is a rare anatomic variant. This study discusses the case of a patient with a C1 lateral mass tumor that surrounded a dominant Right Vertebral Artery (RVA) according to preoperative computed tomography angiography, with a hypoplastic LVA originating from the aortic arch. Surgery was performed, and the patient recovered uneventfully. To date, no study has reported the simultaneous association of two variations (origin and diameter) in the LVA. A deep understanding of abnormalities in the diameter and origin of LVA is a must for neurosurgeons as well as for thoracic and vascular surgeons to conduct surgical procedures.

Figure 1

Three-dimensional reconstructed computed tomography angiography shows the carotid, subclavian, and vertebral arteries. A hypoplastic left vertebral artery originates from the aortic arch and is smaller than the right vertebral artery along its entire course. All mentioned vascular structures show normal caliber and course, smooth intima, and no narrowing or obliteration. AA = aortic arch; BCT = brachiocephalic trunk; LCCA = left common carotid artery; LSCA = left subclavian artery; RCCA = right common carotid artery; RSCA = right subclavian artery; LVA = left vertebral artery; RVA = right vertebral artery.

Figure 2

Computed tomographic angiography demonstrates the anterior-posterior (a), posterior-anterior (b), and lateral (c) views. AA = aortic arch; BCT = brachiocephalic trunk; LCCA = left common carotid artery; LSCA = left subclavian artery; RCCA = right common carotid artery; RSCA = right subclavian artery; LVA = left vertebral artery; RVA = right vertebral artery.