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Case Reports
. 2010 Nov;48(5):465-8.
doi: 10.3340/jkns.2010.48.5.465. Epub 2010 Nov 30.

Cervical radiculopathy caused by vertebral artery loop formation : a case report and review of the literature

Hoon Soo Kim  1 , June Ho Lee, Gene Cheh, Sang-Ho Lee
Affiliations
Case Reports

Cervical radiculopathy caused by vertebral artery loop formation : a case report and review of the literature

Hoon Soo Kim et al. J Korean Neurosurg Soc. 2010 Nov.

Abstract

Vertebral artery loop formation causing encroachment on cervical neural foramen and canal is a rare cause of cervical radiculopathy. We report a case of 61-year-old woman with vertebral artery loop formation who presented with right shoulder pain radiating to her arm for 2 years. Plain radiograph and computed tomography scan revealed widening of the right intervertebral foramen at the C5-6 level. Magnetic resonance imaging and angiogram confirmed the vertebral artery loop formation compressing the right C6 nerve root. We had considered microdecompressive surgery, but the patient's symptoms resolved after conservative management. Clinician should keep in mind that vertebral artery loop formation is one of important causes of cervical radiculopathy. Vertebral artery should be visualized using magnetic resonance angiography in suspected case.

Keywords: Cervical radiculopathy; Magnetic resonance angiography; Vascular anomaly; Vascular compression; Vertebral artery; Vertebral artery loop.

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Figures

Fig. 1
Fig. 1
Left posterior oblique cervical radiograph shows a widening of the intervertebral foramen on the right side at C5-6 caused by erosion of the superior margin of the right C6 pedicle, inferior margin of the right C5 pedicle, and the posterolateral portion of the C5 body (arrow).
Fig. 2
Fig. 2
Axial computed tomography scan obtained at the level C5-6 shows a widening of the right intervertebral foramen (arrow heads).
Fig. 3
Fig. 3
T2-weighted axial (A) and sagittal (B) magnetic resonance images show a signal-void vascular structure in the right C5-6 intervertebral foramen (arrows).
Fig. 4
Fig. 4
A : Axial computed tomography scan obtained at the level C4 body shows erosion of the left lateral portion of C4 vertebral body. B : T2-weighted sagittal magnetic resonance image shows a signal-void vascular structure in the C4 vertebral body (arrows).
Fig. 5
Fig. 5
A : Magnetic resonance angiography shows bilateral vertebral artery loop formation (VALF). B : Axial subvolumetric maximum intensity projection image shows a VALF compressing right C6 nerve root. C : Axial subvolumetric maximum intensity projection image shows a VALF encroaching left lateral portion of C4 vertebral body (arrows).
See this image and copyright information in PMC

References

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