Tortuous vertebral artery triggering vertebral foramen expansion and radiculopathy in a 19-year-old patient: a case repo
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(2020) 14:170
CASE REPORT
Open Access
Tortuous vertebral artery triggering vertebral foramen expansion and radiculopathy in a 19-year-old patient: a case report Ibrahim F. Naldemir* , Elif Nisa Unlu and Omer Onbas
Abstract Background: Arterial tortuosity is a widespread condition commonly occurring in cerebral arteries and often associated with the elderly. Moderate arterial tortuosity is often not symptomatic, but if there is severe tortuosity, various symptoms may occur, depending on the localization. In the literature, many factors have been reported as causing tortuosity in the vertebral arteries. In this case report, considering the age of our patient, we propose that, in addition to these previously reported reasons, congenital factors may also contribute to this situation. Case presentation: We present a case of a 19-year-old Turkish patient with a tortuous vertebral artery causing pain and tingling in the right shoulder and neck. Magnetic resonance imaging revealed vertebral foramen enlargement thought to be secondary to a loop formation in the vertebral artery. The diagnosis was confirmed by magnetic resonance angiography. Conclusions: There are many causes of cervical radiculopathy. Arterial tortuosity, a rare cause of radiculopathy, should be considered as a differential diagnosis. Consideration of the existence of this variation is of great importance in preventing possible dangerous complications during surgery. Keywords: Vertebral artery loop formation, Tortuous vertebral artery, Widening of vertebral foramen, VALF
Introduction Arterial tortuosity is not an uncommon condition and is especially common in cerebral arteries. Moderate arterial tortuosity is often not symptomatic; however, depending on localization and severity, tortuosity may lead to various symptoms. Tortuous vertebral arteries are often associated with the elderly. Here, we present a case of a young patient with a tortuous vertebral artery enlarging the vertebral foramen, extending the adjacent neural foramen, and causing intermittent radiculopathy.
* Correspondence: [email protected] Department of Radiology, Duzce University, Konuralp Yerleşkesi Konuralp Merkez, 81620 Düzce, Turkey
Case presentation A 19-year-old Turkish woman with no history of trauma was admitted to the hospital due to increased right shoulder and neck pain at 2-month intervals. Physical examination revealed cervical axis flattening, right trapezius and paravertebral muscle spasm, tingling in the area, and limitation of neck movement. Cervical magnetic resonance (MR) revealed enlargement of the right vertebral foramen at the C3–C4 level, scalloping on the right side of the vertebral corpus, thinning on the right pedicle, and compression of the nerve root by the vascular structure on the right side (Figs. 1 and 2). Neither bone pathology nor intervertebral disc herniation was observed. The described findings were thought to be due
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, wh
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