Aortic Origin of Left Vertebral Artery: A Case Report

Objective: To study the abnormalities associated with origin and course of vertebral artery and to discuss the embryological & clinical significance. Method: Cadaveric dissection of superior mediastinum showed an abnormal branching pattern of arch of aorta. In addition to the normal branches an extra artery was found to be arising from the arch of aorta in between left common carotid and left subclavian artery. We traced this artery to the neck to describe its course and relation. Observation: The left vertebral artery instead of arising from left subclavian artery took origin from arch of aorta proximal to the left subclavian artery. The artery had a long prevertebral course before entering into the transverse foramen of fourth cervical vertebra instead of sixth. Conclusion: Patients with neurological symptoms and those undergoing surgery in neck and chest region should be carefully screened for an aberrant origin of vertebral artery. The aortic arch branching pattern has to be taken into consideration before any manoeuvre in the local region, so as to avoid any unexpected event in relation to aberrant vertebral artery