title: Vertebral artery loop formation: a frequent cause of cervicobrachial pain.
abstract: METHODS
  Patients with cervicobrachial pain were examined in detail with special attention to vertebral artery loop formation.
  
  
  OBJECTIVE
  To determine the incidence, short-time natural course and response to a conservative approach to vertebral artery loop formation in a group of patients with cervicobrachial pain.
  
  
  BACKGROUND
  Vertebral artery loop formation is reported to be a rare cause of cervicobrachial neuralgia, discovered incidentally during the search for its cause. It can be congenital or acquired, occurring equally in both sexes. Surgical decompression has been the preferred method in the majority of reported cases, with favorable results.
  
  
  METHODS
  One hundred seventy-three patients with cervicobrachial pain were examined in a period of 7 months using physical examination, radiography, and magnetic resonance imaging with or without angiography.
  
  
  RESULTS
  Thirteen patients with a mean age of 43.9 +/- 13.5 years were diagnosed with vertebral artery loop formation. The most common level was C6-C7. Four patients presented with loop formation at two levels. None of the patients had symptoms attributable to intervertebral disc pathology. The complaints were in accordance with the level of the vascular pathology. Complete relief or decrease in pain was observed in all patients with the conservative approach.
  
  
  CONCLUSIONS
  In patients with cervicobrachialgic symptoms and without established discopathy, during the examination of sagittal magnetic resonance images, vertebral artery loop formation should be kept in mind, and in suspected cases, the vertebral artery should be visualized using three-dimensional time of flight magnetic resonance angiography. Vertebral artery-nerve root relation should also be demonstrated using the multiplanar reformatting method from time of flight images. A conservative course of treatment has a favorable outcome.
authors.affiliation: Ultra Imaging Center, Selçuk University Medical School, Konya, Turkey.
authors.forename: Yahya
authors.initials: Y
authors.lastname: Paksoy
authors.forename: Funda Dinç
authors.initials: FD
authors.lastname: Levendoglu
authors.forename: Cemile Oztin
authors.initials: CO
authors.lastname: Ogün
authors.forename: Mehmet Erkan
authors.initials: ME
authors.lastname: Ustün
authors.forename: Tunç Cevat
authors.initials: TC
authors.lastname: Ogün
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D020968:Brachial Plexus Neuritis / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000000981:diagnostic imaging; D019547:Neck Pain / Q000188:drug therapy / Q000209:etiology; D010147:Pain Measurement / Q000187:drug effects; D011859:Radiography; D020069:Shoulder Pain / Q000188:drug therapy / Q000209:etiology; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D014711:Vertebral Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging
chemical_list: D000928:Antidepressive Agents; D000959:Antihypertensive Agents