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Bilateral Type II Persistent Proatlantal Intersegmental Arteries

Published online by Cambridge University Press:  23 September 2014

David Pelz ,
Ranjith K. Menon ,
Rick H. Swartz ,
Richard I. Aviv  and
Sean P. Symons
David Pelz
Affiliation:
Department of Otolaryngology - Head & Neck Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
Ranjith K. Menon
Affiliation:
Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
Rick H. Swartz
Affiliation:
Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
Richard I. Aviv
Affiliation:
Division of Neuroradiology, Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
Sean P. Symons*
Affiliation:
Division of Neuroradiology, Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
*
Division of Neuroradiology, Department of Medical Imaging, Sunnybrook Health Sciences Centre, Departments of Medical Imaging and Otolaryngology - Head & Neck Surgery, University of Toronto, 2075 bayview Avenue, AG31D, Toronto, Ontario, M4N 3M5, Canada. Email: sean.symons@sunnybrook.ca.
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A 64-year-old man with treated hypertension presented with acute left arm and leg weakness. A brain magnetic resonance imaging (MRI) and neck magnetic resonance angiography (MRA) were performed. There was restricted diffusion in the right internal capsule posterior limb consistent with an acute lacunar infarct. The MRA demonstrated aplastic bilateral cervical vertebral arteries (V1 and V2 segments). bilaterally, a variant artery arose from the external carotid just above its origin, extended superiorly then medially, and forming the vertebral artery (V3 and V4 segments). bilaterally, the occipital artery arose from the variant artery at the juncture where it turned medially. The right variant artery terminated intracranially in the right posterior inferior cerebellar artery. The left variant artery continued intracranially to supply the basilar. The appearance was consistent with bilateral persistent proatlantal intersegmental arteries (PPIA) type II.

Type
Neuroimaging Highlight
Information
Canadian Journal of Neurological Sciences , Volume 40 , Issue 6 , November 2013 , pp. 873 - 874
Copyright
Copyright © The Canadian Journal of Neurological 2013

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