Anatomy of the Neck Arteries

Abstract

The anatomy of neck arteries, normal variations, and anastomoses between different arteries is discussed in this chapter. All major arteries of the neck originate from the aortic arch via three main vessels: the brachiocephalic trunk, left common carotid (CCA), and left subclavian arteries. The CCA courses superiorly in the neck, anteromedial to the jugular vein and alongside the vagus nerve. CCA typically divides at the level of C3 or C4 vertebral body into internal and external carotid arteries. The cervical segment of the internal carotid artery (ICA) usually does not have branches in the neck, unless there is remnant of carotid-basilar anastomoses such as the hypoglossal artery or proatlantal artery type I. The external carotid artery (ECA) is the smaller branch of the CCA and runs anteromedial to ICA. It has six branches in the neck before entering the parotid gland and divides into two terminal branches: superficial temporal artery and internal maxillary artery. The ECA supplies most of the neck structures, scalp, and meninges. The vertebral artery is usually the first branch of the subclavian artery, running superiorly in the transverse foramen of C6 to C1 with no cervical branches. It then courses between the C1 and foramen magnum and enters intracranial space. There are extensive anastomoses between carotid and vertebral arteries, the knowledge of which is essential to prevent disastrous complications during interventions.