Fig 1. A, Oblique, volume-rendered CT angiogram projection. Note the left vertebral artery arising directly from the thyrocervical trunk and extending cephalad outside of the transverse foramina of the vertebral bodies (arrows). The suprascapular artery is noted arising directly from this vessel in the lower neck (arrowhead).

B, Posterior, volume-rendered CT angiogram projection. There has been a decompressive occipital craniectomy, and resection of the posterior arch of C1. The left vertebral artery is well seen continuing intracranially (arrows).