Cervical myelopathy caused by the anomalous vertebral artery. A case report.

Abstract

A case of cervical myelopathy caused by an anomalous vertebral artery is reported. To report a case of high cervical myelopathy resulting from spinal cord compression by an anomalous vertebral artery. Authors believe that this is the first reported case in which the nutrient artery to the abnormal artery originated from the posterior inferior cerebellar artery. Although fenestration of the vertebral artery is net an unusual anomaly to the best of the authors knowledge, three cases of high cervical myelopathy resulting from the anomaly were reported. There is no reported case in which an abnormal artery originated from the posterior inferior cerebellar artery. The clinical features of the case are reported and discussed with a review of the previously documented cases. The cord compression war relieved surgically, and the patient's symptoms improved postoperatively. A fenestrated vertebral artery should be included in the differential diagnosis of the upper cervical or the craniovertebral junctional lesions of unknown origin. Magnetic resonance imaging is useful for the diagnosis. In the present case, there was an anomalous branch entered as a nutrient artery from the posterior inferior cerebellar artery. Careful management for similar abnormal arteries includes surgery.