Journal of neurosurgery
T im cervical portion of the ver tebral a r te ry has suffered neglect a t postmor t em studies for various reasons. The inaccessibility of the vessel lying deep in the bony canal, the t ime-consuming procedure of examining it and the technical difficulties associated with this have all contribu ted to its neglect. Added to this, in this count ry we have the very strong views of the mort ic ians forbidding dissection of the major vessels in the neck which they claim interferes with embalming. This has almost invar iably resulted in the examinat ion of only the intracranial portion of the vertebral a r t e ry a t necropsies. I t is not surprising, therefore, tha t there has been poor cliuicopathological correlation. In most published studies on occlusion of the carotid ar tery, no mention is made of the condition of the cervical portion of the vertebral ar tery. Hutchinson and Yates ~ have shown an in t imate relationship of the ver tebral a r tery on its medial aspect to the neurocentral joint within the ver tebra l canal. Osteoarthr i t ic changes with spur format ion could easily impinge on the vessel and result in changes in the wall of the vessel (Fig. 1). These authors Is studied 100 autopsies on pat ients who were selected because they had shown clinical evidence of cerebral ischemia. In these studies 7,~s they showed: 1) Of 83 I=atients examined, 40 had stenosis or occlusion of one or more vessels in the neck. ~) In 7 cases the vertebral arteries alone were ~ffected. 3) Of 100 cases examined, in 55 the ver tebral vessels were affected anti in 77 the carotid vessels were affected by stenosis. 4) The mos t common site of involvement of the Fro. 1. Vertebral angiogram showing kinking of the vessel, probably caused by osteophytes in tile foramen transversarium.