Rubral lateropulsion due to vertebral artery dissection in a patient with Klippel-Feil syndrome.
BACKGROUND
Neurologic deficits in patients with Klippel-Feil syndrome usually are attributed to direct compression of neuronal structures or hypoperfusion secondary to compression of the vertebral arteries by bony abnormalities.


OBJECTIVE
To describe a 38-year-old woman with known Klippel-Feil syndrome who developed lateropulsion.


RESULTS
The results of magnetic resonance imaging were consistent with rubrothalamic stroke. The cerebral angiogram confirmed vertebral artery dissection at the level of her previously observed bony abnormality.


CONCLUSIONS
Hypermobility adjacent to fused vertebrae subjects the vertebral artery to increased shear forces. Thus, Klippel-Feil syndrome may be a predisposing factor for vertebral artery dissection. Moreover, to our knowledge, this case represents the second known case of rubral lateropulsion.
Karimi
Morvarid
M
Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, USA. morvaridkarimi@hotmail.com
Razavi
Mehrdad
M
Fattal
Deema
D
D000328:Adult; D002533:Cerebral Angiography; D002544:Cerebral Infarction / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007714:Klippel-Feil Syndrome / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D009408:Nerve Compression Syndromes / Q000175:diagnosis*; D009460:Neurologic Examination; D012012:Red Nucleus / Q000098:blood supply* / Q000473:pathology; D013786:Thalamic Diseases / Q000150:complications* / Q000175:diagnosis; D020217:Vertebral Artery Dissection / Q000150:complications* / Q000175:diagnosis