Cervical cord compression with myelopathy caused by bilateral persistence of the first intersegmental arteries: case report.

Abstract

Cervical myelopathy induced by vascular compression is rare. We report a case caused by bilateral persistence of the first intersegmental arteries (a vertebral artery anomaly). Myelopathy was successfully treated with vascular decompression. A 66-year-old woman presented with gradually worsening paroxysmal neck and arm pain. Magnetic resonance imaging and angiography demonstrated anomalous intradural courses of both vertebral arteries, compressing the dorsal aspect of the cervical spinal cord. Microvascular decompression was performed with transposition of the arteries, followed by anchoring of the arteries to the dorsolateral dura mater with Gore-Tex bands (W.L. Gore & Associates, Inc., Flagstaff, AZ). The pain disappeared promptly after surgery. Surgical decompression, with anchoring of an anomalous vertebral artery to the dura, can relieve pain and other symptoms resulting from vascular cord compression.