Bilateral aortic origins of the vertebral arteries with right vertebral artery arising distal to left subclavian artery: case report

Surg Neurol. 2007 Feb;67(2):174-6; discussion 176. doi: 10.1016/j.surneu.2006.02.045. Epub 2006 Oct 6.


Background: Bilateral aortic origins of the vertebral arteries are a rare anatomic variant, with fewer than 20 cases reported in the literature. This particular variant has only been reported twice.

Case description: A 35-year-old woman presented to the emergency department after trauma to the head and a witnessed convulsion. Subsequent workup included MRI/MRA, which resulted in identification of the anomaly.

Conclusion: The clinical importance of aortic arch anomalies lies in that it may be a source of misinterpretation, as one may conclude occlusion of the vertebral artery if the aberrant origin is not included in the MRA or CTA imaging parameters. Therefore, it is important to scan through the entire aortic arch to just below the level of the ligamentum arteriosum when performing these noninvasive modalities. In addition, vertebral arteries arising from the aortic arch have an increased risk of dissection.

Publication types

  • Case Reports

MeSH terms

  • Accidents, Traffic
  • Adult
  • Aorta / abnormalities*
  • Aortic Coarctation / diagnosis
  • Aortic Coarctation / etiology
  • Aortic Coarctation / physiopathology
  • Bicycling / injuries
  • Cervical Vertebrae / anatomy & histology
  • Epilepsy, Post-Traumatic / etiology
  • Epilepsy, Post-Traumatic / physiopathology
  • Female
  • Functional Laterality / physiology
  • Humans
  • Magnetic Resonance Angiography / standards
  • Magnetic Resonance Imaging / standards
  • Predictive Value of Tests
  • Radiography
  • Subclavian Artery / abnormalities
  • Vertebral Artery / abnormalities*
  • Vertebral Artery / diagnostic imaging
  • Vertebral Artery / physiopathology
  • Vertebrobasilar Insufficiency / diagnosis
  • Vertebrobasilar Insufficiency / etiology*
  • Vertebrobasilar Insufficiency / physiopathology