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Microvascular decompression of a C-2 segmental-type vertebral artery producing trigeminal hypesthesia.

Abstract
The authors report a case of trigeminal hypesthesia caused by compression of the spinal cord by a C-2 segmental-type vertebral artery (VA) that was successfully treated with microvascular decompression. Aberrant intradural VA loops have been reported as causes of cervical myelopathy, some of which improved with microvascular decompression. A 52-year-old man presented with progressive complaints of headache, dizziness, left facial numbness, and left upper-extremity paresthesia that worsened when turning his head to the right. Magnetic resonance imaging of the cervical spine showed the left VA passing intradurally between the axis and atlas, foregoing the C-1 foramen transversarium, and impinging on the spinal cord. The patient underwent left C-1 and C-2 hemilaminectomies followed by microvascular decompression of an aberrant VA loop compressing the spinal cord. The patient subsequently reported complete resolution of symptoms.
AuthorsJonathan N Sellin, Baraa Al-Hafez, Edward A M Duckworth
JournalJournal of neurosurgery (J Neurosurg) Vol. 121 Issue 4 Pg. 919-23 (Oct 2014) ISSN: 1933-0693 [Electronic] United States
PMID24972125 (Publication Type: Case Reports, Journal Article)
Topics
  • Cervical Vertebrae
  • Humans
  • Hypesthesia (etiology)
  • Male
  • Microvascular Decompression Surgery
  • Middle Aged
  • Nerve Compression Syndromes (complications, surgery)
  • Spinal Cord Diseases (complications, surgery)
  • Trigeminal Nerve Diseases (etiology)
  • Vertebral Artery (abnormalities)

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