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Updated: Aug 15, 2026

Permanent Cerebral Vessel Occlusion via Double Ligature and Transection
Published on: July 21, 2013
Tortuosity of the vertebral artery resulting in vertebral erosion
1Logan College of Chiropractic, Department of Radiology, Chesterfield, MO 63006-1065, USA.
Objective:
To discuss the case of a patient with unilateral vertebral artery tortuosity and dilatation resulting in vertebral body and transverse foramen erosion. An emphasis is placed on diagnostic imaging.
Clinical Features:
A 45-year-old man had a frozen shoulder and headaches. Previous arm pain, numbness, and a cold extremity were the result of occlusion of the subclavian artery and had been treated with a subclavian-carotid bypass procedure.
Intervention And Outcome:
As a result of the angiographic detection of the left vertebral artery dilatation and tortuosity and the concomitant hypoplastic right vertebral artery, high-velocity, low-amplitude manipulation of the cervical spine was contraindicated. However, the patient's symptoms were not related to these findings. Alternatively, low-force manipulation of the cervical spine, shoulder range of motion and muscle techniques were used, and the patient's symptoms diminished significantly with improved shoulder range of motion.
Conclusion:
Clinicians need to be alert to clinical presentations and appropriate imaging protocols in cases of suggested vertebral artery anomaly.
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