Noel Torres, Antonio Lara, Daniel J. Slaktoski, Paola A. Rodríguez, Fabiola Ramos, Desere A. Gitulli, Elisamuel Pastrana and Geoffrey D. Guttmann*
University of Medicine and Health Sciences, Basseterre, St Kitts & Nevis
*Correspondence to: Geoffrey D. Guttmann, University of Medicine and Health Sciences, Camps, St. Kitts and Nevis
Received: Dec 14, 2024; Accepted: Dec 24, 2024; Published: Dec 31, 2024
Citation: Torres N, Lara A, Slaktoski DJ, Rodríguez PA, Ramos F, et al. (2024) Stellate Ganglion Encircling Atypical Vertebral Artery. J Anatomical Variation and Clinical Case Report 2:113. DOI: https://doi.org/10.61309/javccr.1000113
Copyright: ©2024 Torres N. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
ABSTRACT
We present the case of an unusual course of the right vertebral artery with intra-foraminal entrance at C4, enveloped by an abnormal stellate ganglion. Case reports and literature mention these abnormalities independently, but it is uncommon to have them presented simultaneously. The close association of the vertebral artery and the stellate ganglion, especially in patients who harbor anomalies, could potentially cause lesions to the ganglion during clinical procedures. The anatomical variations are clinically significant in relation to procedures like endovascular intervention, stellate ganglion blocks, and anterior cervical surgical procedures. Complications of the sympathetic trunk and its ganglion can range from Horner’s Syndrome to severe hypertensive reactions. Clinical procedures should require the use of magnetic resonance imaging, computerized tomography, and ultrasound imaging, to reduce the risk of possible complications. Ultrasound techniques reduce the risk of harming the vertebral artery, while remaining vastly more practical and affordable than other techniques. This discovery allows for future breakthroughs in prevention and intervention of cervical vessels of iatrogenic injury during surgical procedures involving cervical vessels.
Keywords: Stellate ganglion; Vertebral artery; Sympathetic trunk; Inferior cervical ganglion
Figure 1: Illustrates the regional right neck anatomy of the anterior cervical vertebrae. va vertebral artery, lsg loop of the stellate ganglion, sg Stellate Ganglion, st sympathetic trunk, cb Cardiac Branch, ac ascending cervical, ants anterior scalene muscle, bct brachiocephalic trunk, c5 Right C5 Root, c6 Right C6 Root, c7 Right C7 Root, cc common carotid, cs Carotid Sinus, cnx vagus nerve, in Internal Carotid artery, it internal thoracic artery, ii suprascapular artery, sub subclavian artery, tc transverse cervical artery, th inferior thyroid artery. The upper left corner includes a macro showcasing the loop of the sg enveloping the va.
Disclaimer: Appearance of the common carotid artery has been altered due to the embalming process.
