Compression of the C-2 root by a rare anomalous ectatic vertebral artery

Sharma, Rewati Raman; Parekh, Harshad C.; Prabhu, Sujit S.; Gurusinghe, Nihal; Bertolis, George

doi:10.3171/jns.1993.78.4.0669

Cited by 89 publications

(32 citation statements)

References 5 publications

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“…Tortuosity of the VA, in particular, has been shown to produce extradural cervical radiculopathy as well as intradural brainstem dysfunction by direct compression. 1,6,7,[9][10][11][12][13][17][18][19][20]23,25,29,30 Such tortuosity has been observed postmortem in anatomical studies, as well as in vivo on radiography, MRI, or via traditional angiography. 2,5,28,35 Classically, Jannetta linked vascular compression of the trigeminal nerve to trigeminal neuralgia, and showed that microvascular decompression of the affected nerve could produce symptomatic relief.…”

Section: Discussionmentioning

confidence: 99%

Microvascular decompression of a C-2 segmental-type vertebral artery producing trigeminal hypesthesia

Sellin

Al-Hafez²,

Duckworth³

2014

JNS

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The authors report a case of trigeminal hypesthesia caused by compression of the spinal cord by a C-2 segmental-type vertebral artery (VA) that was successfully treated with microvascular decompression. Aberrant intradural VA loops have been reported as causes of cervical myelopathy, some of which improved with microvascular decompression. A 52-year-old man presented with progressive complaints of headache, dizziness, left facial numbness, and left upper-extremity paresthesia that worsened when turning his head to the right. Magnetic resonance imaging of the cervical spine showed the left VA passing intradurally between the axis and atlas, foregoing the C-1 foramen transversarium, and impinging on the spinal cord. The patient underwent left C-1 and C-2 hemilaminectomies followed by microvascular decompression of an aberrant VA loop compressing the spinal cord. The patient subsequently reported complete resolution of symptoms.

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Section: Discussionmentioning

confidence: 99%

Microvascular decompression of a C-2 segmental-type vertebral artery producing trigeminal hypesthesia

Sellin

Al-Hafez²,

Duckworth³

2014

JNS

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“…A etiologia, nos casos considerados sintomáticos, pode variar de acordo com os segmentos afetados: traumatismos crânio encefálicos 16 e cervicais 17,18 , irritação dos linfonodos cervicais sobre o nervo 19 ; processos inflamatórios ou degenerativos da coluna cervical 17,[20][21][22] ; neurossífilis 23 ; neuroma do nervo occipital maior 24 ; arterite temporal 25 ; estenose foraminal 26 ; malformação de Chiari 27 ; compressão vascular de C2 28,29 ; fibrosites 30 ; meningite 4 ; espasmos musculares 31 ; fraturas não traumáticas de C 3 -C 4…”

Section: Localização Localização Fatores Desencadeantes Tratamentounclassified

Nevralgia do occipital maior associada a lesão osteolítica occipital: relato de caso

Piovesan¹,

Werneck

Kowacs

et al. 1999

Arq. Neuro-Psiquiatr.

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RESUMO -A distribuição anatômica do nervo occipital maior durante o seu trajeto permite íntima relação com estruturas musculares, tendinosas, vasculares e ósseas. A quebra deste relacionamento pode originar a sua irritação e cefaléia. Descrevemos uma associação rara: sexo feminino; 50 anos; cefaléia com evolução de 2 anos; localizada em região occipital direita irradiando-se para região hemicrânica e supraorbitária direita; espontânea e ou desencadeada pela digito compressão sobre a região de emergência do nervo occipital maior ao nível do trapézio; duração de 30 minutos; compressiva; moderada intensidade; sem fenômenos autonômicos associados; sem resposta terapêutica com o bloqueio anestésico do nervo occipital maior. Investigação radiológica mostrou lesão osteolítica localizada e aderida ao nível da inserção do tendão do músculo trapézio. A melhora total dos sintomas após descompressão cirúrgica do nervo permite relacionar esta lesão aos sintomas álgicos apresentados, compatíveis com nevralgia do occipital maior. PALAVRAS-CHAVE: cefaléia, lesão osteolítica, nevralgia do occipital maior, neuropatia compressiva, osso occipital.Greater occipital neuralgia associated to an occipital osteolytic lesion: case report ABSTRACT -The anatomic distribution of the greater occipital nerve during its path permits a close relationship with muscular structures, tendons, vessels and bones. The rupture of this relationship can origin its irritation and headache. We describe an uncommon association between an osteolytic lesion on occipital bone and greater occipital nerve. The patient, female 50, has been presenting headache for two years on the right occipital region spreading to the hemicranic and ipsilateral supraorbital region. The symptoms started spontanously or by pressure on the trapezius tendon. The pain lasted about 30 minutes, compressive, mild intensity, with no autonomic symptoms and no improvement after the infiltration in the greater occipital nerve. The total improvement of the symptoms after releasing the nerve has allowed us to associate this lesion to the presence of algic symptoms.KEY WORDS: entrapment neuropathy, greater occipital neuralgia, headache, occipital bone.Os nervos occipital maior, menor e o trigêmeo fornecem aferências sensitivas para os neurônios de segunda ordem, localizados ao nível do núcleo caudado do trigêmeo e dos primeiros segmentos cervicais 1,2 . Estímulos dolorosos sobre o nervo occipital maior proporcionam alteração no metabolismo destes neurônios e, se forem sustentados, o aparecimento de síndromes álgicas cranianas

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“…9 On radiographic imaging it was noted that an ectatic VA was compressing the exiting nerve root at C1-2. A posterior MVD was conducted, with the placement of an oxidized cotton plug to separate the exiting root from the vessel.…”

Section: -9mentioning

confidence: 99%

A novel sling technique for microvascular decompression of a rare anomalous vertebral artery causing cervical radiculopathy

Tandon

Chandela²,

Langer

et al. 2013

FOC

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Cervical radiculopathy secondary to compression from congenital anomalous vertebral arteries (VAs) is a known entity. Patients present with a variety of symptoms ranging from upper-extremity numbness to true occipital neuralgia. Treatment options for extracranial tortuous VAs include conservative management or some form of surgical microvascular decompression (MVD). The authors report on a patient with a congenital anomalous VA loop causing cervical nerve root compression. Successful MVD was conducted with relief of the patient's symptoms. A novel sling technique was used for mobilization of the VA. To the authors' knowledge, this is the first MVD described utilizing this technique.

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Compression of the C-2 root by a rare anomalous ectatic vertebral artery

Cited by 89 publications

References 5 publications

Microvascular decompression of a C-2 segmental-type vertebral artery producing trigeminal hypesthesia

Microvascular decompression of a C-2 segmental-type vertebral artery producing trigeminal hypesthesia

Nevralgia do occipital maior associada a lesão osteolítica occipital: relato de caso

A novel sling technique for microvascular decompression of a rare anomalous vertebral artery causing cervical radiculopathy

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