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Case report
Republished: The transclival artery: a variant persistent carotid–basilar arterial anastomosis not previously reported
  1. Jared D Kirkland1,
  2. Brian C Dahlin2,
  3. William T O'Brien1,2
  1. 1Department of Radiology, David Grant Medical Center, Travis AFB, California, USA
  2. 2Department of Radiology, UC Davis, Sacramento, California, USA
  1. Correspondence to Dr Jared D Kirkland, Department of Radiology, David Grant Medical Center, 101 Bodin Circle, Travis AFB, CA 94535, USA; jared.kirkland{at}


During embryological development, primitive anastomoses exist between the carotid and vertebrobasilar arteries. These anastomoses typically regress or are incorporated into the developing vasculature. Persistence beyond fetal development, however, results in vascular anomalies that alter haemodynamic flow with a predisposition for aneurysm formation. The carotid–vertebrobasilar anastomoses mirror the primitive communications and include (from most to least common) the trigeminal, hypoglossal, proatlantal and otic arteries. The hypoglossal and proatlantal variants extend through the hypoglossal canal or foramen magnum, respectively. We present a previously undescribed variant of these persistent fetal anastomoses, the ‘transclival artery’, which courses through its own transclival skull base canal/foramen.

  • Aneurysm
  • Angiography
  • Artery
  • Blood Flow
  • Congenital

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  • Republished with permission from BMJ Case Reports Published 13 July 2016; doi:10.1136/bcr-2016-012464

  • Correction notice This article has been updated since it first published Online First. Figure 2 has been corrected.

  • Contributors All contributors to this case and the written case report are acknowledged as authors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.