Maldevelopmental pathology of the vertebral artery in infancy and childhood

The vertebral artery (VA), whose embryogenesis differs from that of any oth er vessel, is characterized by a great variety of malformations and anomali es. Some of the malformations are truly pathological (that is symptomatic); the anomalies are either found by chance post-morten or by angiography. Al l of these should be kept in mind by the surgeon approaching the deep cervi cal and craniospinal regions as well as by the interventional radiologist. In the context of a literature review we discuss the width and length anoma lies of the VA, tortuosity and kinking, course anomalies, duplication and f enestration, persistence of primitive arteries, and anomalies of collateral branches. Other pathologies of the cervical VA associated exclusively with genetic diseases, such as spontaneous aneurysms and arteriovenous fistulae in neurofibromatosis type 1 are also considered.