Medknow Publications on behalf of the Neurological Society of India
Abstract
Objective: To study the course, relationships, branches and possible
anomalies of the vertebral artery in the suboccipital region in adult
Indian cadavers. Materials and Methods: Twenty-one suboccipital
segment vertebral artery specimens from embalmed, Indian adult cadavers
were dissected and studied. Dissection was performed using
microsurgical instruments and was carried out from the skin up to the
vertebral artery in layers. The course, relationships and the branches
of the vertebral artery were studied and measurements were taken using
Vernier calipers. The readings obtained were corroborated with the
measurements derived from the digital images using a computer.
Observations: All the vertebral arteries had a tortuous course and were
covered with rich venous plexuses. None of the specimens had an
anomalous course. The artery was divided into a vertical segment (Vv)
between C2 and C1 vertebra and a horizontal segment (Vh) from the C1
transverse foramina to its dural entry. The mean diameter of the artery
was 4.8mm. The shortest distance of Vv segment from the dural tube was
16.1mm, and the distance from the C2 ganglion was 7.2mm. The average
length of the Vv segment was 15mm and the average length of the Vh
segment was 35.6mm. The average of the shortest distance between the
vertebral artery and the midline was 13.4mm. Conclusion: The vertebral
artery has a tortuous course and is prone to accidental iatrogenic
injury, which can result in devastating neurological sequelae depending
on contralateral vertebral artery flow. A thorough anatomical knowledge
of this segment is essential for the surgeon who intends to operate in
this area
