{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,4,3]],"date-time":"2022-04-03T05:03:13Z","timestamp":1648962193254},"reference-count":9,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground: <\/jats:title>\nTortuous\/abnormal vertebral arteries (VAs) sometimes cause neurovascular compression syndromes (NVCs), such as trigeminal neuralgia, hemifacial spasm, and, rarely, myelopathy\/radiculopathy. Abnormalities\/tortuosity of the VA at the level of the atlas and axis are of particular note; these may be characterized by a persistent first intersegmental artery (PFIA) and C2 segmental type of VA. Herein, we report a 72-year-old male who presented with cervical myelopathy\/radiculopathy due to bilateral tortuosity of the PFIA resulting in spinal cord compression at the craniocervical junction.<\/jats:p>\n<\/jats:sec>\n\nCase Description: <\/jats:title>\nA 72-year-old male presented with cervical pain when turning his neck and progressive gait disturbance. The neurological examination demonstrated a moderate myeloradicular syndrome (Nurick Grade III). The magnetic resonance revealed compression of the medulla and spinal cord due to tortuosity of both dorsal VA at the C1 vertebral level. The three-dimensional computed tomography angiogram confirmed bilateral PFIA running medially. In addition, the left side of VA forms fenestration. Surgery through a C1 laminectomy and midline small suboccipital craniectomy, both VAs were transposed and tethered to the ipsilateral dura utilizing Aron Alpha and vinyl prostheses. In addition, a large vinyl prosthesis was inserted between both VAs to protect them from contacting the spinal cord. Following this decompressive procedure, the patient\u2019s symptoms fully resolved, and he remains asymptomatic 10 years later exhibiting no recurrent vascular pathology.<\/jats:p>\n<\/jats:sec>\n\nConclusion: <\/jats:title>\nMicrovascular decompression of anomalous VAs contributing to cord compression at the C1 level was safe and effective in a 72-year-old male.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_240_2020","type":"journal-article","created":{"date-parts":[[2020,5,30]],"date-time":"2020-05-30T08:59:25Z","timestamp":1590829165000},"page":"136","update-policy":"http:\/\/dx.doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A case report of microvascular decompression for cervical myelopathy and radiculopathy caused by tortuous and abnormal bilateral vertebral artery"],"prefix":"10.25259","volume":"11","author":[{"given":"Naoki","family":"Omura","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yangtae","family":"Park","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shunsuke","family":"Ikeda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideki","family":"Tanabe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2020,5,30]]},"reference":[{"key":"10.25259\/SNI_240_2020\/ref-1","first-page":"54","article-title":"Nerve compression syndromes in the posterior cranial fossa","volume":"116","author":"Baldauf","year":"2019","journal-title":"Dtsch Arztebl Int"},{"key":"10.25259\/SNI_240_2020\/ref-2","doi-asserted-by":"crossref","first-page":"347","DOI":"10.3340\/jkns.2013.54.4.347","article-title":"Cervical compressive myelopathy due to anomalous bilateral vertebral artery","volume":"54","author":"Ha","year":"2013","journal-title":"J Korean Neurosurg Soc"},{"key":"10.25259\/SNI_240_2020\/ref-3","doi-asserted-by":"crossref","first-page":"196","DOI":"10.22603\/ssrr.2018-0065","article-title":"Atlantoaxial fixation in a patient with bilateral persistent first intersegmental vertebral artery anomaly using an O-arm navigation system: A case report","volume":"3","author":"Kashiro","year":"2019","journal-title":"Spine Surg Relat Res"},{"key":"10.25259\/SNI_240_2020\/ref-4","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.3389\/fneur.2019.01075","article-title":"Vertebral artery compression syndrome","volume":"10","author":"Li","year":"2019","journal-title":"Front Neurol"},{"key":"10.25259\/SNI_240_2020\/ref-5","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1001\/archneur.63.2.234","article-title":"Vertebral artery compression of the medulla","volume":"63","author":"Savitz","year":"2006","journal-title":"Arch Neurol"},{"key":"10.25259\/SNI_240_2020\/ref-6","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1227\/01.NEU.0000069537.22198.50","article-title":"Cervical cord compression with myelopathy caused by bilateral persistence of the first intersegmental arteries: Case report","volume":"53","author":"Takahashi","year":"2003","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_240_2020\/ref-7","doi-asserted-by":"crossref","first-page":"E611","DOI":"10.1097\/BRS.0b013e31817c6c17","article-title":"The long-term follow-up of surgical treatment for cervical myelopathy with severe nape and upper arm pain caused by the anomalous vertebral artery: Case report","volume":"33","author":"Takei","year":"2008","journal-title":"Spine (Phila Pa 1976)"},{"key":"10.25259\/SNI_240_2020\/ref-8","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/s00234-011-0849-z","article-title":"Vertebral artery variations at the C1-2 level diagnosed by magnetic resonance angiography","volume":"54","author":"Uchino","year":"2012","journal-title":"Neuroradiology"},{"key":"10.25259\/SNI_240_2020\/ref-9","doi-asserted-by":"crossref","first-page":"101","DOI":"10.4103\/sni.sni_73_18","article-title":"A case report: C2 radiculopathy induced by neck flexion due to the cord compression of C2 segmental type vertebral artery relieved by microvascular decompression","volume":"9","author":"Yamada","year":"2018","journal-title":"Surg Neurol Int"}],"container-title":["Surgical Neurology 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