A rare case of coexisting vascular anomalies and developmental variant of the brachiocephalic vessels

This article presents a rare case of coexisting vascular anomalies and developmental variants of the brachiocephalic vessels in a female patient who reported headaches triggered by food intake. The anomalies included: arteria lusoria, an aberrant right subclavian artery arising directly from the aortic arch and passing posterior to the esophagus; origin of the right vertebral artery from the right common carotid artery; origin of the left vertebral artery from the aortic arch; high vertebral artery entry points with hypoplasia; and excessive S-shaped tortuosity of the left internal carotid artery. This case is of particular interest due to the exceptional rarity of coexisting vascular anomalies and developmental variants in a single patient, qualifying it as a clinical curiosity. Variations in the origin and course of aortic arch branches may lead to altered cerebral hemodynamics and be associated with cerebrovascular disorders or neurological symptoms. Identifying atypical courses of the brachiocephalic vessels is crucial during preoperative assessment, as anomalous vascular anatomy may result in serious complications during surgical or endovascular interventions.