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Multiple symptomatic vertebral artery loops treated with posterior cervical fusion
Nader S Dahdaleh1, Gregory W Albert, David M Hasan
1Department of Neurosurgery, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, Iowa 52242, USA.
Summary
Multiple vertebral artery (VA) loops can cause rare but serious symptoms like presyncope and radiculopathy. Posterior cervical fusion effectively treated a patient with complex VA loops, resolving symptoms.
Area of Science:
- Neurology
- Vascular Surgery
- Neurosurgery
Background:
- Vertebral artery (VA) loops are uncommon vascular anomalies.
- Symptomatic VA loops present diagnostic and management challenges.
- Symptoms can include vertebrobasilar insufficiency and radiculopathy.
Observation:
- A 55-year-old male experienced 5 years of presyncope and left C5 radiculopathy.
- Symptoms were aggravated by neck movement (flexion/extension).
- Clinical examination identified complex left VA loops at C2/3 and C4 levels.
Findings:
- The patient underwent posterior cervical fusion surgery.
- Post-operatively, presyncope resolved completely.
- Cervical radiculopathy symptoms showed significant improvement.
Implications:
- Posterior cervical fusion is a viable surgical option for managing symptomatic multiple VA loops.
- This case highlights the effectiveness of surgical intervention for this rare condition.
- Further research may elucidate optimal surgical techniques for complex VA loop management.