Topics

Topic

design image
Left vertebral artery (cervical part)

The left vertebral artery (V1–V2 segments) is the proximal cervical portion of the vertebral artery arising from the first part of the subclavian artery. It ascends through the neck to supply the posterior circulation of the brain, including the brainstem, cerebellum, and posterior cerebral hemispheres.

The cervical portion consists of:

  • V1 (pre-foraminal segment): Originates from the subclavian artery and ascends to enter the transverse foramen of C6 (sometimes C5).

  • V2 (foraminal segment): Passes vertically through the transverse foramina of C6 to C2, lying anterior to the cervical nerve roots and posterolateral to the vertebral bodies, enveloped by perivascular connective tissue and sympathetic plexus.

This artery is vulnerable to atherosclerosis, dissection, compression from cervical vertebrae, or traumatic injury, making imaging evaluation critical in stroke risk assessment, trauma, or surgical planning.

Function

  • Supplies posterior circulation of the brain including brainstem, cerebellum, occipital lobes, and inner ear

  • Maintains vertebrobasilar perfusion

  • Participates in collateral circulation through the circle of Willis

  • Supports spinal cord perfusion via medullary and radicular branches

Synonyms

  • Cervical vertebral artery

  • Left VA (cervical segment)

  • V1–V2 vertebral artery segments

MRI Appearance

T1-weighted images:

  • The cervical vertebral artery appears as a flow void (black tubular structure) within the soft tissue lateral to the cervical vertebrae

  • Surrounded by intermediate to high signal fat in the vertebral column

  • Vessel wall is usually not visible unless thickened or diseased

T2-weighted images:

  • Shows a similar flow void pattern

  • High signal may indicate slow flow, thrombosis, or dissection

  • Helps differentiate artery from adjacent lymph nodes, veins, and soft tissue

STIR (Short Tau Inversion Recovery):

  • Normal vertebral artery maintains low signal flow void

  • Surrounding edema or perivascular inflammation appears hyperintense, useful in trauma or vasculitis

T1 Post-Contrast (Gadolinium-enhanced):

  • Cervical vertebral artery enhances brightly along the lumen, outlining the vessel course

  • Useful for detecting dissections, aneurysms, stenosis, or arteriovenous fistulae

  • Vessel wall enhancement indicates inflammation or pathology

CT Appearance:

  • On non-contrast CT, the vertebral artery is barely visible as a soft tissue density within the transverse foramina

  • On CT angiography, it appears as a hyperdense tubular structure, sharply delineating the lumen and course

  • Enables evaluation of stenosis, occlusion, aneurysm, or bony compression

  • Cervical vertebrae are clearly visualized, providing anatomical correlation with transverse foramina

MRI images

Left Vertebral Artery (Cervical Part) mri coronal image -img-00000-00000

MRI images

Left Vertebral Artery (Cervical Part) mri axial image