Document Detail

Anterior spinal artery as a collateral channel in cases of bilateral vertebral arterial steno-occlusive diseases.
MedLine Citation:
PMID:  17296984     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: We report 6 cases of retrograde flow through the anterior spinal artery (ASA) from cervical vertebral artery (VA) to intracranial distal VA because the perfusion from bilateral vertebral arteries was tenuous. Its hemodynamic and clinical implications are discussed. METHODS: In association with bilateral steno-occlusive disease of vertebral arteries, 6 cases of retrograde flow through ASA were reviewed in terms of clinical and angiographic characteristics. All 6 patients presented with stroke in the posterior fossa and underwent conventional angiography as part of diagnostic evaluation and/or therapeutic intervention. RESULTS: On the angiography, 2 patients showed bilateral VA occlusion, and the other 4 patients showed VA occlusion on 1 side and severe stenosis in the other VA. Distal perfusion by ASA was prominent in 2, and not prominent in 4. Reversal or disappearance of the retrograde flow through ASA was observed after successful recanalization of the occluded VA in 4 patients. In 1 patient, increased perfusion through ASA was observed because the stenosed VA was completely occluded. CONCLUSION: When the vertebral arteries were occluded bilaterally or when a single VA was occluded and the other carried a severe stenosis and, as a result, the basilar arterial blood supply was tenuous, retrograde flow through ASA could be observed. This is a potentially important source of collateral supply to the posterior fossa neural contents. The degree and extent of perfusion via this collateral channel varied depending on presence of other collateral routes and patency of the vertebrobasilar junction.
H-S Kang; M H Han; S H Kim; O-K Kwon; H G Roh; Y C Koh; Y C Ko
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  28     ISSN:  0195-6108     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-02-13     Completed Date:  2007-04-03     Revised Date:  2008-02-14    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  222-5     Citation Subset:  IM    
Department of Neurosurgery, Konkuk University Hospital, Seoul, Korea.
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MeSH Terms
Aged, 80 and over
Brain Stem / blood supply
Cerebral Angiography
Cerebrovascular Circulation
Collateral Circulation*
Middle Aged
Severity of Illness Index
Spinal Cord / blood supply*
Vertebral Artery / physiopathology,  radiography
Vertebrobasilar Insufficiency / physiopathology*,  radiography*
Erratum In:
AJNR Am J Neuroradiol. 2007 Apr;28(4):796
Note: Ko, Y C [corrected to Koh, Y C]

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