Possible compression of the atlantal segment of the vertebral artery in occipitalisation

The current study evaluates the passage of the atlantal segment of the vertebral artery through the atlas to the cranial cavity in the case of occipitalisation, and searches for potential bony obstacles that constrict the lumen of the vertebral artery. Morphometric analysis was performed of the ossified atlanto-occipital articulation of the dry adult male skull, particularly in the region of the posterior arch of the atlas. The distance between the floor of the right groove for the vertebral artery and the occipital bone was measured using a digital sliding caliper. On the left side, measurements of the diameters of the inlet and outlet of the canal for the vertebral artery were performed using the same technique. Fusion of the left portion of the posterior arch of the atlas with the occipital bone caused significant narrowing of the space around the normally existing groove for the vertebral artery, and converted it into the canal. The size of the intracranial opening of the canal for the vertebral artery was measured as 3.8 mm x 4.7 mm, whereas the inlet to the canal was 5.4 mm x 7.0 mm. The diameter of the canal decreases, particularly at the entrance into the cranial cavity; therefore, compression of the vertebral artery within the canal seems to be possible.