Open AccessCervical Cord Compression with Myelopathy Caused by Bilateral Persistence of the First Intersegmental Arteries: Case Report
Author(s) -
Toshiyuki Takahashi,
Teiji Tominaga,
Tamer Hassan,
Takashi Yoshimoto
Publication year - 2003
Publication title -
neurosurgery/neurosurgery online
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.485
H-Index - 34
eISSN - 1081-1281
pISSN - 0148-396X
DOI - 10.1227/01.neu.0000069537.22198.50
Subject(s) - medicine , myelopathy , spinal cord , decompression , cord , vertebral artery , magnetic resonance imaging , dura mater , surgery , spinal cord compression , anterior spinal artery , artery , microvascular decompression , radiology , angiography , trigeminal neuralgia , psychiatry
OBJECTIVE AND IMPORTANCE Cervical myelopathy induced by vascular compression is rare. We report a case caused by bilateral persistence of the first intersegmental arteries (a vertebral artery anomaly). Myelopathy was successfully treated with vascular decompression. CLINICAL PRESENTATION A 66-year-old woman presented with gradually worsening paroxysmal neck and arm pain. Magnetic resonance imaging and angiography demonstrated anomalous intradural courses of both vertebral arteries, compressing the dorsal aspect of the cervical spinal cord. INTERVENTION Microvascular decompression was performed with transposition of the arteries, followed by anchoring of the arteries to the dorsolateral dura mater with Gore-Tex bands (W.L. Gore & Associates, Inc., Flagstaff, AZ). CONCLUSION The pain disappeared promptly after surgery. Surgical decompression, with anchoring of an anomalous vertebral artery to the dura, can relieve pain and other symptoms resulting from vascular cord compression.