Abstract
Background. Aneurysms of the extracranial vertebral artery are rare and can provide a diagnostic and therapeutic challenge. Methods. We reviewed the clinical history of a patient presenting with cervical radiculopathy, who harboured an extracranial vertebral artery aneurysm eroding the cervical spine. Results. CT Angiography and MR Angiography set the diagnosis, by revealing a left C5-C6 vertebral artery aneurysm with cervical root impingement. Bony reconstruction depicted enlargement of the C6 transverse foramen and a marked enlargement of the C6-C7 intravertebral foramen. The lesion was treated by intravascular proximal vertebral artery occlusion. Conclusions. Extracranial vertebral artery aneurysms require a high index of clinical suspicion. This is the first report of a vertebral artery pseudoaneurysm presenting with bony erosion, which supports a less minacious portrayal of vertebral artery aneurysms.
Highlights
Aneurysms of the extracranial vertebral artery are rare and can provide a diagnostic and therapeutic challenge
We reviewed the clinical history of a patient presenting with cervical radiculopathy, who harboured an extracranial vertebral artery aneurysm eroding the cervical spine
This is the first report of a vertebral artery pseudoaneurysm presenting with bony erosion, which supports a less minacious portrayal of vertebral artery aneurysms
Summary
Aneurysms of the extracranial vertebral artery are rare and can provide a diagnostic and therapeutic challenge. She started experiencing a burning sensation in her affected fingers and forearm and intense pain in her neck and left shoulder At that point she consulted our department for a possible removal of her “neurinoma.” Under the impression that the Magnetic Resonance Imaging (MRI) performed a few weeks earlier at another center was technically unsatisfying and nondiagnostic, we performed an urgent CT scan of the cervical region with 3D reconstruction. The possibility of a vascular lesion was raised, so a contrast-enhanced MRI/MR Angiography (MRA) scan of the cervical region and of the brain was performed This confirmed the findings of the CT, again revealing an ovoid 2 cm × 1,6 cm lesion clearly adherent to the left vertebral artery, causing enlargement of the aforementioned foramina and enhancing homogenously after intravenous contrast administration (Figure 2). Having established adequate contralateral blood supply, the patient was treated with warfarine, and endovascular proximal occlusion of the left vertebral artery
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