Posterior inferior cerebellar artery infarction originating at C1-2 after C1-2 fusionopen access
- Authors
- Won, D.; Lee, J.M.; Park, I.S.; Lee, C.H.; Lee, K.; Kim, J.-Y.; Lee, Y.S.
- Issue Date
- Oct-2019
- Publisher
- Korean Neurotraumatology Society
- Keywords
- Atlanto-axial fusion; Brain infarction; Posterior inferior cerebellar artery; Vertebral artery
- Citation
- Korean Journal of Neurotrauma, v.15, no.2, pp 192 - 198
- Pages
- 7
- Journal Title
- Korean Journal of Neurotrauma
- Volume
- 15
- Number
- 2
- Start Page
- 192
- End Page
- 198
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/71734
- DOI
- 10.13004/kjnt.2019.15.e27
- ISSN
- 2234-8999
2288-2243
- Abstract
- Vertebral artery injuries associated with C1 lateral mass screw insertion rarely occur during C1-2 fusion. The posterior inferior cerebellar artery (PICA) is uncommonly located at the C1 lateral mass insertion position. A 71-year-old woman with atlanto-axial subluxation and cord compression underwent C1-2 fusion. Sixth nerve palsy and diplopia were detected postoperatively, and decreased consciousness occurred on postoperative day 4. Brain magnetic resonance image (MRI) and computed tomography (CT) revealed PICA infarction. In the preoperative CT angiography, the PICA originated between the C1 and C2 level. In the postoperative CT scan, the PICA was not visible. The patient was treated conservatively for two weeks and recovered. PICA originating between the C1 and C2 level comprises 1.1–1.3% of cases. Therefore, vertebral artery anomalies should be evaluated prior to C1-2 fusion to prevent vessel injuries. © 2019 Korean Neurotraumatology Society.
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