Differences between left and right suboccipital and intracranial vertebral artery dimensions: an influence on blood flow to the hindbrain?
Tóm tắt
Although vertebral artery (VA) blood flow is adequate in normal circumstances, reduction in the dimensions of the vessel because of atherosclerosis, or compression or stretching, may lead to hindbrain hypoxia with serious clinical manifestations. Such effects may be more pronounced in VAs that are naturally smaller than the norm. Because normative data for the suboccipital (VA3) and intracranial (VA4) vertebral artery are not readily available, it was the aim of the present study to measure the dimensions of these distal parts of the VA, to inform professional practice of the possible influence of different vessel dimensions on blood flow to the hindbrain.
The study was a laboratory‐based observational or descriptive study. A total of 40 and 54 left and right, suboccipital and intracranial parts of the VA (
The histological structure of the VA was typical of a muscular or distributing artery. Although, in the total number of specimens, no statistically significant differences were found between left and right sides in either part of the vessel, a larger left than right VA4 was demonstrated in the females. The VA3 was significantly larger than VA4 in males and females, and all dimensions in both parts of the vessel were greatest in the older age group.
Reduced VA blood flow, whether because of atherosclerosis or compression or stretching of the vessel, is more likely to occur in arteries that are smaller than normal. This information is of value to clinicians in avoiding further compromising the VA and its blood flow during professional practice. Copyright © 2004 Whurr Publishers Ltd.
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Tài liệu tham khảo
Abd EI‐Bary TH, 1995, Microsurgical anatomy of the atlantal part of the vertebral artery, Surgical Neurology, 44, 192
Anderson JE, 1989, Grant's Atlas of Anatomy
Bolton PS, 1989, Failure of clinical tests to predict cerebral ischemia before neck manipulation, Journal of Manipulative and Physiological Therapeutics, 12, 304
Boonstra H, 1983, Cervical tissue shrinkage by formaldehyde fixation, paraffin wax embedding, section cutting and mounting, Virchows Archives A Pathology, Anatomy and Histopathology, 40, l95
Fawcett DW, 1994, A Textbook of Histology
Junqueira LC, 1995, Basic Histology
Lin LI‐K, 1989, A concordance correlation coefficient to evaluate reproducibility, Biomechanics, 45, 255
Lyness SS, 1974, Neurological deficit following cervical manipulation, Surgical Neurology, 2, l21
Macchi C, 1996, The inner diameter of human intra‐cranial vertebral artery by color Doppler method, Italian Journal of Anatomy and Embryology, 10, 81
Moore KL, 1992, Clinically Oriented Anatomy
Parkin PJ, 1978, Vertebral artery occlusion following manipulation of the neck, New Zealand Medical Journal, 88, 41
Romanes GJ, 1986, Cunningham's Manual of Practical Anatomy
Sherman MR, 1987, Pathogenesis of vertebral artery occlusion following cervical spine manipulation, Archives of Pathological Laboratory Medicine, 111, 51
Stopford JSB, 1916, The arteries of the pons and medulla oblongata, Journal of Anatomy, 11, 131
Thiel HW, 1991, Gross morphology and pathoanatomy of the vertebral arteries, Journal of Manipulative and Physiological Therapeutics, 14, l33
Williams PL, 1989, Gray's Anatomy