Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
권호 표지
DOI QR코드

DOI QR Code

Cervical Compressive Myelopathy due to Anomalous Bilateral Vertebral Artery

  • Ha, Eun Jin (Department of Neurosurgery, Seoul National University College of Medicine) ;
  • Lee, Soo Eon (Department of Neurosurgery, Seoul National University College of Medicine) ;
  • Jahng, Tae-Ahn (Department of Neurosurgery, Seoul National University College of Medicine) ;
  • Kim, Hyun-Jib (Department of Neurosurgery, Seoul National University College of Medicine)
  • Received : 2013.05.02
  • Accepted : 2013.10.10
  • Published : 2013.10.28
Download PDF
⟨ Previous Next ⟩

Abstract

We report a very rare case of cervical compressive myelopathy by an anomalous bilateral vertebral artery (VA) entering the spinal canal at the C1 level and compressing the spinal cord. A 70-year-old woman had been suffering from progressive gait disturbance. Magnetic resonance imaging revealed that a bilateral VA at the V4 segment had abnormal courses and caused compression to the high cervical cord. VA repositioning was performed by anchoring a suture between the artery and around the arachnoid membrane and dentate ligament, and then, microvascular decompression using a Teflon sponge was done between the VA and the spinal cord. The weakness in the patient improved in the lower extremity after the operation. Anomalous VA could be one of the rare causes of cervical compressive myelopathy. Additionally, an anchoring suture and microvascular decompression around the VA could be a sufficient and safe method to indirectly decompress the spinal canal.

Keywords

References

  1. Furumoto T, Nagase J, Takahashi K, Itabashi T, Iai H, Ishige N : Cervical myelopathy caused by the anomalous vertebral artery. A case report. Spine (Phila Pa 1976) 21 : 2280-2283, 1996 https://doi.org/10.1097/00007632-199610010-00022
  2. Goel A, Shah A : Trigeminal neuralgia in the presence of ectatic basilar artery and basilar invagination : treatment by foramen magnum decompression. J Neurosurg 111 : 1220-1222, 2009 https://doi.org/10.3171/2009.6.JNS09469
  3. Hasegawa T, Kubota T, Ito H, Yamamoto S : Symptomatic duplication of the vertebral artery. Surg Neurol 20 : 244-248, 1983 https://doi.org/10.1016/0090-3019(83)90061-7
  4. Jannetta PJ : Observations on the etiology of trigeminal neuralgia, hemifacial spasm, acoustic nerve dysfunction and glossopharyngeal neuralgia. Definitive microsurgical treatment and results in 117 patients. Neurochirurgia (Stuttg) 20 : 145-154, 1977
  5. Satoh S, Yamamoto N, Kitagawa Y, Umemori T, Sasaki T, Iida T : Cervical cord compression by the anomalous vertebral artery presenting with neuralgic pain. Case report. J Neurosurg 79 : 283-285, 1993 https://doi.org/10.3171/jns.1993.79.2.0283
  6. Suzuki S, Tsuchita H, Kurokawa Y, Kitami K, Sohma T, Takeda T : New method of MVD using a vascular tape for neurovascular compression involving the vertebrobasilar artery--report of two cases. Neurol Med Chir (Tokyo) 30 : 1020-1023, 1990 https://doi.org/10.2176/nmc.30.1020
  7. Takahashi T, Tominaga T, Hassan T, Yoshimoto T : Cervical cord compression with myelopathy caused by bilateral persistence of the first intersegmental arteries : case report. Neurosurgery 53 : 234-237; discussion 237, 2003 https://doi.org/10.1227/01.NEU.0000069537.22198.50
  8. Takahashi Y, Sugita S, Uchikado H, Miyagi T, Tokutomi T, Shigemori M : Cervical myelopathy due to compression by bilateral vertebral arteries--case report. Neurol Med Chir (Tokyo) 41 : 322-324, 2001 https://doi.org/10.2176/nmc.41.322
  9. Takei H, Sagae M, Chiba K, Ogino T : The long-term follow-up of surgical treatment for cervical myelopathy with severe nape and upper arm pain caused by the anomalous vertebral artery : case report. Spine (Phila Pa 1976) 33 : E611-E613, 2008 https://doi.org/10.1097/BRS.0b013e31817c6c17
  10. Tokuda K, Miyasaka K, Abe H, Abe S, Takei H, Sugimoto S, et al. : Anomalous atlantoaxial portions of vertebral and posterior inferior cerebellar arteries. Neuroradiology 27 : 410-413, 1985 https://doi.org/10.1007/BF00327604
  11. Watanabe K, Hasegawa K, Takano K : Anomalous vertebral artery-induced cervical cord compression causing severe nape pain. Case report. J Neurosurg 95 (1 Suppl) : 146-149, 2001

Cited by

  1. Vertebral Artery Compression Syndrome vol.10, pp.None, 2019, https://doi.org/10.3389/fneur.2019.01075
  2. A case report of microvascular decompression for cervical myelopathy and radiculopathy caused by tortuous and abnormal bilateral vertebral artery vol.11, pp.None, 2013, https://doi.org/10.25259/sni_240_2020