Brain infarction due to vertebral artery dissection caused by a bone protrusion from the condylar fossa in a juvenile case

A 16-year-old boy presented with multiple posterior circulation ischemic strokes resulting from vertebral artery (VA) dissection. Three-dimensional computed tomography showed aberrant sub-occipital bone protuberance, proximal to the VA dissection. Since the patient was a habitual neck cracker, VA di...

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Bibliographic Details
Published in:British journal of neurosurgery 2020-04, Vol.34 (2), p.232-234
Main Authors: Fujii, Mutsumi, Ohgushi, Miki, Chin, Takaaki
Format: Article
Language:English
Subjects:
Adolescent
Bone and Bones
Brain Infarction
Dissection
Humans
Male
Vertebral Artery
Vertebral Artery Dissection
Vertebrobasilar Insufficiency
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Summary:A 16-year-old boy presented with multiple posterior circulation ischemic strokes resulting from vertebral artery (VA) dissection. Three-dimensional computed tomography showed aberrant sub-occipital bone protuberance, proximal to the VA dissection. Since the patient was a habitual neck cracker, VA dissection was thought to result from the impact shock of the rotational head movement. This could be due to either the osseous prominence or the compression between the prominence and the C1. Although it is a rare etiology of Bow Hunter's syndrome, VA dissection due to sub-occipital bone spur because of neck cracking should be considered in the diagnosis of Bow Hunter's syndrome in juvenile patients.
ISSN:0268-8697
1360-046X
DOI:10.1080/02688697.2018.1435850