{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:06:59Z","timestamp":1756339619141,"version":"3.44.0"},"reference-count":10,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,9,30]]},"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:p>Vertebrobasilar ischaemia happens for a myriad of reasons. Among the rarest is the existence of a foramen arcuale (FA). This condition results from the ossification of the lateral edge of the posterior atlantooccipital membrane, closing, completely or partially, the top of this groove, turning it into a foramen or a channel. The estimated prevalence of this anatomical variant is around 9% for the complete form. It is postulated that entrapment of vertebral artery can occur. We share the case of a man in his 30s presenting with sudden imbalance, vertigo, vomiting and hiccups. Neurological observation disclosed Babinski-Nageotte syndrome. CT scan revealed left vertebral artery (VA) signs of dissection at its third segment (VA3), occlusion of its ipsilateral fourth segment (VA4) and bilateral FA. MRI confirmed ischaemic lesions in vertebrobasilar territory. The patient underwent surgical excision of contralateral FA. No new neurological adverse events occurred after 2 years of follow-up.<\/jats:p>","DOI":"10.1136\/bcr-2024-260225","type":"journal-article","created":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T19:10:45Z","timestamp":1733857845000},"page":"e260225","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Babinski-Nageotte syndrome after vertebral artery dissection and foramen arcuale"],"prefix":"10.1136","volume":"17","author":[{"given":"Ana Jo\u00e3o","family":"Marques","sequence":"first","affiliation":[{"name":"Neurology, Centro Hospitalar de Tras-os-Montes e Alto Douro EPE, Vila Real, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina","family":"Azoia","sequence":"additional","affiliation":[{"name":"Neurology, Centro Hospitalar de Tras-os-Montes e Alto Douro EPE, Vila Real, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lu\u00eds","family":"Rocha","sequence":"additional","affiliation":[{"name":"Neurosurgery, Centro Hospitalar Universitario de Santo Antonio, Porto, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ricardo","family":"Almendra","sequence":"additional","affiliation":[{"name":"Neurology, Centro Hospitalar de Tras-os-Montes e Alto Douro EPE, Vila Real, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,12,10]]},"reference":[{"key":"2025082712195351000_17.12.e260225.1","doi-asserted-by":"publisher","DOI":"10.1148\/rg.2019180126"},{"key":"2025082712195351000_17.12.e260225.2","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.wneu.2018.07.038","article-title":"Arcuate Foramen: Anatomy, Embryology, Nomenclature, Pathology, and Surgical Considerations","volume":"118","author":"Ahn","year":"2018","journal-title":"World Neurosurg"},{"key":"2025082712195351000_17.12.e260225.3","doi-asserted-by":"crossref","first-page":"276","DOI":"10.3171\/2017.1.SPINE161092","article-title":"Prevalence of foramen arcuale and its clinical significance: a metaanalysis of 55,985 subjects","volume":"27","author":"P\u0119kala","year":"2017","journal-title":"J Neurosurg Spine"},{"key":"2025082712195351000_17.12.e260225.4","doi-asserted-by":"publisher","DOI":"10.1017\/S0012162201000901"},{"key":"2025082712195351000_17.12.e260225.5","first-page":"191","article-title":"Dissection des art\u00e8res vert\u00e9brales apr\u00e8s manipulation du rachis cervical. A propos d\u2019un cas [Dissection of the vertebral arteries after manipulation of the cervical spine","volume":"65","author":"Cellerier","year":"1984","journal-title":"J Radiol"},{"key":"2025082712195351000_17.12.e260225.6","doi-asserted-by":"publisher","DOI":"10.3171\/spi.2007.6.1.6"},{"key":"2025082712195351000_17.12.e260225.7","doi-asserted-by":"crossref","first-page":"e402","DOI":"10.1016\/j.wneu.2019.02.063","article-title":"Conservative Management of Unruptured Spontaneous Intracranial Vertebral Artery Dissection","volume":"126","author":"Kim","year":"2019","journal-title":"World Neurosurg"},{"key":"2025082712195351000_17.12.e260225.8","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.08.1688"},{"key":"2025082712195351000_17.12.e260225.9","doi-asserted-by":"publisher","DOI":"10.3340\/jkns.2008.44.3.109"},{"key":"2025082712195351000_17.12.e260225.10","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.jocn.2018.05.008","article-title":"Presence of a foramen arcuale as a possible cause for headaches and migraine: Systematic review and meta-analysis","volume":"54","author":"P\u0119kala","year":"2018","journal-title":"J Clin Neurosci"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-260225","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T19:19:57Z","timestamp":1756322397000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-260225"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12]]},"references-count":10,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12,10]]},"published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1136\/bcr-2024-260225"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-260225","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2024,12]]}}}