Tortuous vertebral artery triggering vertebral foramen expansion and radiculopathy in a 19-year-old patient: a case report

Abstract

Background Arterial tortuosity is a widespread condition commonly occurring in cerebral arteries and often associated with the elderly. Moderate arterial tortuosity is often not symptomatic, but if there is severe tortuosity, various symptoms may occur, depending on the localization. In the literature, many factors have been reported as causing tortuosity in the vertebral arteries. In this case report, considering the age of our patient, we propose that, in addition to these previously reported reasons, congenital factors may also contribute to this situation. Case presentation We present a case of a 19-year-old Turkish patient with a tortuous vertebral artery causing pain and tingling in the right shoulder and neck. Magnetic resonance imaging revealed vertebral foramen enlargement thought to be secondary to a loop formation in the vertebral artery. The diagnosis was confirmed by magnetic resonance angiography. Conclusions There are many causes of cervical radiculopathy. Arterial tortuosity, a rare cause of radiculopathy, should be considered as a differential diagnosis. Consideration of the existence of this variation is of great importance in preventing possible dangerous complications during surgery.

Radiological Assessment of Extracranial Vertebral Artery Variations: A Computed Tomography Angiography Study

“…The vertebral arteries (VAs), critical blood vessels of posterior brain circulation, can exhibit a variety of anatomical variations which have an important implication in medical procedures, specifically in the context of spine surgeries [1,2]. During cervical spine surgeries and endovascular interventions, the VA is at risk of injury due to its close relationship to the vertebrae and the presence of anomalies, such as variant origin [3][4][5], unusual entrance [6][7][8][9][10], and course in the cervical spine [11,12], hypoplasia [13], and tortuosity [14]. These anomalies make it more difficult to identify and access the VAs during surgeries and may lead to inadvertent injuries, which can have detrimental consequences for patients [2].…”