Diagnosis and Treatment of Vertebrobasilar Insufficiency and Pain Syndrome in Patients with Kimmerle anomaly

Abstract

Patients with vertebrobasilar insufficiency and pain syndrome, which are quite common in the practice of a neurologist and neurosurgeon, require a comprehensive examination to clarify the etiological factor of the development of vertebrobasilar insufficiency and differential diagnosis. One of the reasons for it is Kimmerle's anomaly—this is a variant of the development of the C1 vertebra, which has an additional bone arch growing from the posterolateral part of the lateral mass of the Atlas above the furrow of the vertebral artery to the posterior arch, as well as ossification of part of the Atlanto-occipital ligament. In addition to the clinical and neurological examination method, the diagnostic complex includes spondylography, computed tomography, and magnetic resonance imaging of the cervical spine, ultrasound Dopplerography, and direct angiography. The dependence of the frequency of neurological syndromes and their severity on the severity of the anomaly and the age of patients has been established. An algorithm for the complex diagnosis and treatment of this pathology has been developed.