ABSTRACT
During embryological development, primitive anastomoses exist between the carotid and vertebrobasilar arteries. These anastomoses typically regress or are incorporated into the developing vasculature. Persistence beyond fetal development, however, results in vascular anomalies that alter haemodynamic flow with a predisposition for aneurysm formation. The carotid-vertebrobasilar anastomoses mirror the primitive communications and include (from most to least common) the trigeminal, hypoglossal, proatlantal and otic arteries. The hypoglossal and proatlantal variants extend through the hypoglossal canal or foramen magnum, respectively. We present a previously undescribed variant of these persistent fetal anastomoses, the 'transclival artery', which courses through its own transclival skull base canal/foramen.
Subject(s)
Basilar Artery/abnormalities , Basilar Artery/diagnostic imaging , Carotid Artery, Internal/abnormalities , Carotid Artery, Internal/diagnostic imaging , Vascular Malformations/diagnostic imaging , Aneurysm/diagnostic imaging , Aneurysm/etiology , Computed Tomography Angiography , Female , Follow-Up Studies , Humans , Middle Aged , Vascular Malformations/complicationsABSTRACT
During embryological development, primitive anastomoses exist between the carotid and vertebrobasilar arteries. These anastomoses typically regress or are incorporated into the developing vasculature. Persistence beyond fetal development, however, results in vascular anomalies that alter haemodynamic flow with a predisposition for aneurysm formation. The carotid-vertebrobasilar anastomoses mirror the primitive communications and include (from most to least common) the trigeminal, hypoglossal, proatlantal and otic arteries. The hypoglossal and proatlantal variants extend through the hypoglossal canal or foramen magnum, respectively. We present a previously undescribed variant of these persistent fetal anastomoses, the 'transclival artery', which courses through its own transclival skull base canal/foramen.
Subject(s)
Basilar Artery/abnormalities , Carotid Arteries/abnormalities , Vertebral Artery/abnormalities , Aneurysm/therapy , Basilar Artery/diagnostic imaging , Carotid Arteries/diagnostic imaging , Computed Tomography Angiography , Female , Humans , Middle Aged , Vertebral Artery/diagnostic imagingABSTRACT
Primary hyperparathyroidism is predominantly caused by a single parathyroid adenoma. Knowledge of normal and ectopic locations of parathyroid glands is crucial to help guide surgeons who plan targeted unilateral parathyroidectomy to reduce surgical time and risk. We describe a female patient with clinical primary hyperparathyroidism who underwent a failed initial parathyroidectomy, with subsequent imaging localizing an ectopic parathyroid adenoma in the carotid sheath.
