title: Vertebral artery dissection related to basilar impression: case report.
abstract: A 50-year-old man with myelopathy secondary to basilar impression developed bilateral vertebral artery dissection after undergoing treatment with 8 pounds of cervical traction. The vertebral artery dissection resulted in vertebrobasilar insufficiency and posterior circulation stroke. In this report, the current management philosophies in the treatment of basilar impression are discussed, and the pertinent neurovascular anatomy is illustrated. This report suggests that vertebral artery injury may result from attempted reduction of severe basilar impression. Regardless of the cause of cranial settling, the risk of vertebral artery injury with cervical traction should be considered in patients with severe basilar impression.
authors.affiliation: Department of Surgery, University of Michigan, Ann Arbor, USA.
authors.forename: L D
authors.initials: LD
authors.lastname: Dickinson
authors.forename: G F
authors.initials: GF
authors.lastname: Tuite
authors.forename: G P
authors.initials: GP
authors.lastname: Colon
authors.forename: S M
authors.initials: SM
authors.lastname: Papadopoulos
mesh_terms: D000784:Aortic Dissection / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D002532:Intracranial Aneurysm / Q000188:drug therapy / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010985:Platybasia / Q000628:therapy*; D015912:Thrombolytic Therapy; D014143:Traction; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage; D014711:Vertebral Artery / Q000293:injuries*; D014715:Vertebrobasilar Insufficiency / Q000188:drug therapy / Q000209:etiology*; D014859:Warfarin / Q000008:administration & dosage
chemical_list: D014859:Warfarin; D014568:Urokinase-Type Plasminogen Activator