Right vertebral artery agenesis

Case contributed by Oussama Aloulou
Diagnosis almost certain

Presentation

Left sided numbness. ?stroke ?space occupying lession

Patient Data

Age: 45 years
Gender: Male
This study is a stack
2D axial
MRA TOF
This study is a stack
Coronal MRA
Subtraction
Axial
TOF
This study is a stack
3D Time of
flight
This study is a stack
Axial 2D
MRA TOF
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Info

The whole course of the right vertebral artery could not be visualized.

Most likely a normal variant in keeping with absent right vertebral artery.

Case Discussion

The patient initially presented with vague neurological symptoms. On intra-cranial CTA the right vertebral artery was not seen and thought to be occluded. Thus, an MRA was performed which showed complete absence of the right vertebral artery from its origin (right subclavian artery).

Fortunately, its absence/agenesis had no effect on the basilar artery which formed as a continuity from the left vertebral artery with no implication of the circle of Willis.

Incidental note made of the left vertebral artery arising directly from the aortic arch.

Co author by Dr Maha Mahmoud Sallam.

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