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Vertebral Artery Anomaly Causing C2 Suboccipital Neuralgia, Relieved by Neurovascular Decompression
Author(s) -
Trimble Christopher,
Reeves Alexa,
Pare Laura,
Tsai Fong
Publication year - 2013
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/j.1552-6569.2011.00602.x
Subject(s) - medicine , vertebral artery , neurovascular bundle , neck pain , intervertebral foramen , decompression , spinal cord , radiology , angiography , myelography , basilar artery , surgery , anatomy , lumbar , alternative medicine , pathology , psychiatry
ABSTRACT We report imaging and surgical findings of a symptomatic 40‐year‐old male with an anomalous left vertebral artery. MR, CT myelography, angiography, and intraoperative photos demonstrate the vertebral artery entering the thecal sac at the C1‐C2 intervertebral foramen and compressing the dorsal C2 nerve rootlets against the cord. Open microvascular decompression alleviated the patient's long‐standing suboccipital and posterior cervical neck pain. An embryologic review of the vertebral and lateral spinal artery systems reveals possible developmental explanations for this variant. Intradural course of the vertebral artery at C2 is one of the few symptomatic developmental vertebral artery anomalies. Recognition of this condition is important because surgical intervention can alleviate associated neck pain.