PMC3841921_01
(a) Cerebral angiogram of the right vertebral artery showing a normal course and flow of the artery. (b) Dynamic right vertebral artery angiogram with the head turned showing complete flow obstruction
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F1
(a-d) Computerized tomography angiogram of the head and neck demonstrating both the aberrant right condylar bone spur (arrow) and its close proximity to the right vertebral artery
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F2
A dynamic computerized tomography angiogram performed with the patient's head in rotated position showed a near complete occlusion of the V3 segment of the right VA resulting from an anomalous spur emanating from his right occipital condyle that pinched off his VA between the C1 ring and this condylar spur [Figure 2].
(a) Cerebral angiogram of the right vertebral artery demonstrating a dissection and associated thrombus (arrow) secondary to intermittent condylar bone spur compression. (b) Cerebral angiogram of the left vertebral artery. The right vertebral artery has been occluded with coil embolization both proximally and distally, trapping the thrombus. The right PICA is preserved through a right AICA-PICA variant
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F3
The right VA was sacrificed with coil embolization and trapping of a 4 mm thrombus over the dissected segment [Figure 3].