Recurrent torticollis caused by dissecting vertebral artery aneurysm in a pediatric patient: results of endovascular treatment by use of coil embolization: case report.
OBJECTIVE
Torticollis is a symptom that can be related to different pathological mechanisms ranging from simple to life-threatening conditions. We report a child with recurrent torticollis caused by an intracranial dissecting vertebral artery aneurysm. This is a very rare condition in childhood, and it was resolved successfully with endovascular treatment.


METHODS
The patient was a 10-year-old boy with a 4-year history of left recurrent torticollis, followed by hemiparesis, dysarthria, dysmetria, and tremor. Brain magnetic resonance imaging and digital angiography detected a dissecting aneurysm involving the fourth segment of the left vertebral artery.


METHODS
The patient underwent endovascular treatment. Coil embolization, followed by histoacryl injection into the lesion, provided complete obliteration of the aneurysmal sac.


CONCLUSIONS
The patient's postoperative course was characterized by a dramatic disappearance of symptoms and signs within a few hours of the intervention. No relapses of symptoms occurred during a follow-up period of 18 months. This is the first report of a child in whom recurrent torticollis was related to a dissecting vertebral artery aneurysm. Although long-term results of vertebral artery coil embolization remain to be elucidated, the method seems reliable and effective in treatment of these vascular lesions in pediatric patients.
Grosso
Salvatore
S
Department of Pediatrics, University of Siena, Siena, Italy.
Mostardini
Rosa
R
Venturi
Carlo
C
Bracco
Sandra
S
Casasco
Alfredo
A
Berardi
Rosario
R
Balestri
Paolo
P
D015901:Angiography, Digital Subtraction; D002533:Cerebral Angiography; D002648:Child; D004621:Embolization, Therapeutic; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D012008:Recurrence; D014103:Torticollis / Q000209:etiology*; D016896:Treatment Outcome; D020217:Vertebral Artery Dissection / Q000150:complications* / Q000175:diagnosis / Q000628:therapy