In rare cases, the anterior spinal artery (black arrow) may arise from the same pedicle as the feeder to the shunt (shunting zone, asterisk; draining vein,

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Lateral skull radiograph performed in our patient at age 4 years shows cystoperitoneal shunt connected to a VP shunt via a Y connector (dashed arrow, reservoir.

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Presentation transcript:

In rare cases, the anterior spinal artery (black arrow) may arise from the same pedicle as the feeder to the shunt (shunting zone, asterisk; draining vein, white arrow). In rare cases, the anterior spinal artery (black arrow) may arise from the same pedicle as the feeder to the shunt (shunting zone, asterisk; draining vein, white arrow). The anterior spinal artery can be identified by the following: 1) its ascending course along the nerve root, 2) its hairpin course at the midline, and 3) the straight course once it reaches the midline of the cord. The vein does not reach the midline via the ascending nerve root but instead via a horizontal and more tortuous course. Embolization in patients with this condition is extremely dangerous, and surgical options may be considered a safer approach. T. Krings, and S. Geibprasert AJNR Am J Neuroradiol 2009;30:639-648 ©2009 by American Society of Neuroradiology