Congenital anomaly of the posterior arch of the atlas: a rare risk factor for posterior circulation stroke

We report an extremely rare case involving a posterior arch anomaly of the atlas, causing a vertebral artery dissection (VAD) induced posterior circulation stroke. A 16-year-old girl was admitted to hospital because of new onset dizziness. VAD related multiple infarction in the posterior circulation...

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Bibliographic Details
Published in:BMJ case reports 2017-01, Vol.2017, p.bcr2016012731
Main Authors: Ouyang, Zhi-yuan, Qiu, Min-jian, Zhao, Zhe, Wu, Xiao-bing, Tong, Lu-sha
Format: Article
Language:English
Subjects:
Adolescent
Aneurysms
Atlanto-Axial Joint - abnormalities
Cervical Atlas - abnormalities
Congenital diseases
Dizziness - etiology
Family medical history
Female
Humans
Incidental Findings
Joint Instability - diagnosis
Joint Instability - etiology
Magnetic Resonance Angiography
Multimodal Imaging
Neuroimaging
Stroke
Stroke - etiology
Tomography, X-Ray Computed
Vertebral Artery Dissection - diagnosis
Vertebral Artery Dissection - etiology
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Summary:We report an extremely rare case involving a posterior arch anomaly of the atlas, causing a vertebral artery dissection (VAD) induced posterior circulation stroke. A 16-year-old girl was admitted to hospital because of new onset dizziness. VAD related multiple infarction in the posterior circulation was revealed. The congenital posterior arch anomaly of the atlas, along with instability of the atlantoaxial joint, were discovered accidentally during follow-up. This is the first case of ischemic stroke related to atlantal posterior arch aplasia and atlantoaxial instability. Although rare, it reminds us that investigation of the craniovertebral junction should be considered when stroke occurs in young patients.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2016-012731