Right-sided aortic arch with mirror image branching
Updates to Case Attributes
An octogenarian with cardiovascular risk factors presented with vertigo-like dizziness. A vestibular source was ruled out clinically. No focal neurological deficit. Referred for CT head and CTA head and neck - vertebrobasilar insufficiency?
Not only did CTA not reveal any stenosis, but his neck arteries and intracranial arteries were extremely well-preserved for his age (i.e. almost entirely devoid of atherosclerosis). He did, however, have two concurrent developmental variants that rendered his posterior circulation tenuous: aplasia of the right PCom and PICA termination of a hypoplastic left vertebral artery.
Incidental finding of right-sided aortic arch with mirror image branching; the order of vessel takeoff from the aortic arch is as follows: left brachiocephalic artery, right common carotid artery, right subclavian artery.The elderly patient's neck arteries and intracranial arteries were extremely well-preserved for his age (i.e. almost entirely devoid of atherosclerosis).
-<p>Incidental finding of <a title="Right-sided aortic arch" href="/articles/right-sided-aortic-arch-2">right-sided aortic arch</a> with mirror image branching; the order of vessel takeoff from the aortic arch is as follows: left brachiocephalic artery, right common carotid artery, right subclavian artery.<br>The elderly patient's neck arteries and <a title="Intracranial arteries" href="/articles/intracranial-arteries">intracranial arteries</a> were extremely well-preserved for his age (i.e. almost entirely devoid of atherosclerosis).</p>- +<p>An octogenarian with cardiovascular risk factors presented with vertigo-like dizziness. A vestibular source was ruled out clinically. No focal neurological deficit. Referred for CT head and CTA head and neck - <a title="Vertebrobasilar insufficiency" href="/articles/vertebrobasilar-insufficiency">vertebrobasilar insufficiency</a>?</p><p>Not only did CTA not reveal any stenosis, but his neck arteries and <a href="/articles/intracranial-arteries">intracranial arteries</a> were extremely well-preserved for his age (i.e. almost entirely devoid of atherosclerosis). He did, however, have two concurrent developmental variants that rendered his posterior circulation tenuous: aplasia of the right PCom and PICA termination of a hypoplastic left vertebral artery.</p><p>Incidental finding of <a href="/articles/right-sided-aortic-arch-2">right-sided aortic arch</a> with mirror image branching; the order of vessel takeoff from the aortic arch is as follows: left brachiocephalic artery, right common carotid artery, right subclavian artery.</p><p> </p><p> </p>
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