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Cervical abnormalities causing vertebral artery dissection in children

Cara L Sedney1, Charles L Rosen

  • 1Department of Neurosurgery, West Virginia University, Morgantown, West Virginia 26506-9183, USA.

Journal of Neurosurgery. Pediatrics
|March 3, 2011
PubMed

Insights

Vertebral artery dissection (VAD) in children, though rare, is a growing cause of pediatric stroke. This study highlights bony cervical abnormalities as a key underlying cause, necessitating advanced imaging for accurate diagnosis and treatment.

Area of Science:

  • Pediatric Neurology
  • Vascular Surgery
  • Neuroradiology

Background:

  • Vertebral artery dissection (VAD) is an uncommon yet significant cause of stroke in children.
  • Traditionally attributed to trauma or spontaneous causes, recent research identifies underlying conditions like bony abnormalities, connective tissue diseases, and infections.

Observation:

  • Presents two pediatric cases of VAD linked to bony cervical abnormalities.
  • Both cases required distinct surgical interventions for symptom management.
  • Accurate diagnosis relied on cervical spine CT to identify bone anatomy and VAD etiology.

Findings:

  • Bony cervical abnormalities were identified as the cause of VAD in both pediatric patients.
  • Case 1: Treated with suboccipital decompression and endovascular vertebral artery sacrifice.
  • Case 2: Managed with surgical decompression of the foramen transversarium at C-1 and C-2.

Implications:

  • Highlights the importance of considering bony cervical abnormalities in pediatric VAD.
  • Emphasizes the role of cervical spine CT in diagnosing VAD causes beyond spontaneous or traumatic origins.
  • Demonstrates the efficacy of tailored surgical approaches for VAD management in children.

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