Abstract:
OBJECTIVE:Our goal was to increase the safety of anterior cervical discectomy, a routine surgery performed by neurosurgeons worldwide, in the face of vertebral artery (VA) anomalies. CLINICAL PRESENTATION:A 59-year-old woman had an intraoperative injury of the left VA during elective anterior cervical discectomy and fusion from C3 to 7. Retrospective analysis of her magnetic resonance images showed bilateral anomalous VAs. Intervention postoperatively, a pseudoaneurysm developed that was subsequently coiled. The patient underwent embolization of the pseudoaneurysm and sacrifice of the parent vessel by endovascular neurosurgical techniques. She had no neurological sequelae but did have some difficulty swallowing. CONCLUSION:Radiologists, neuroradiologists, and surgeons should note the location and course of the VA in their routine evaluation of cervical magnetic resonance images. Neuroradiologists should alert surgeons to the possibility of anomalous VAs that are at risk of injury during surgery. Ultimately, it remains the responsibility of the surgeon to carefully review the images, assess for vascular anomalies, and plan the surgery accordingly.
journal_name
Neurosurgeryjournal_title
Neurosurgeryauthors
Gantwerker BR,Baaj AA,Maughan PH,McDougall CG,White WLdoi
10.1227/01.NEU.0000374858.18717.33subject
Has Abstractpub_date
2010-09-01 00:00:00pages
E874-5; discussion E875issue
3eissn
0148-396Xissn
1524-4040journal_volume
67pub_type
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