Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Usefulness of Intraoperative Monitoring during Microsurgical Decompression of Cervicomedullary Compression Caused by an Anomalous Vertebral Artery

  • Kim, Sung Tae (Department of Neurosurgery, Busan Paik Hospital, Inje University School of Medicine) ;
  • Paeng, Sung Hwa (Department of Neurosurgery, Busan Paik Hospital, Inje University School of Medicine) ;
  • Jeong, Dong Mun (Department of Neurosurgery, Busan Paik Hospital, Inje University School of Medicine) ;
  • Lee, Kun Soo (Department of Neurosurgery, Busan Paik Hospital, Inje University School of Medicine)
  • Received : 2013.09.26
  • Accepted : 2014.03.12
  • Published : 2014.12.28
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Abstract

We report a case of cervicomedullary compression by an anomalous vertebral artery treated using microsurgical decompression with intraoperative monitoring. A 68-year-old woman presented with posterior neck pain and gait disturbance. MRI revealed multiple abnormalities, including an anomalous vertebral artery that compressed the spinal cord at the cervicomedullary junction. Suboccipital craniectomy with C1 laminectomy was performed. The spinal cord was found to be compressed by the vertebral arteries, which were retracted dorsolaterally. At that time, the somatosensory evoked potential (SSEP) changed. After release of the vertebral artery, the SSEP signal normalized instantly. The vertebral artery was then lifted gently and anchored to the dura. There was no other procedural complication. The patient's symptoms improved. This case demonstrates that intraoperative monitoring may be useful for preventing procedural complications during spinal cord microsurgical decompression.

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References

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