title: Positional occlusion of the vertebral artery in a case of rheumatoid atlantoaxial subluxation presenting with multiple cerebral and cerebellar infarction.
abstract: We report an uncommon case of positional occlusion of the vertebral artery associated with rheumatoid arthritis (RA). Plain radiography showed reducible atlantoaxial subluxation, and dynamic vertebral arteriography demonstrated positional occlusion of the left vertebral artery. The patient was treated with C1-2 posterior fusion and has since experienced no recurrent symptoms. Insufficiency of the vertebrobasilar artery is a relatively uncommon complication with cervical lesions in RA patients. However, when RA patients manifest recurrent cerebral and cerebellar symptoms, this condition should be kept in mind and actions taken to avoid further irreversible cerebral damage. Recommended imaging methods include vertebral dynamic lateral plain radiography of the cervical spine and vertebral arteriography at multiple cervical positions.
authors: Department of Orthopaedic Surgery, National Hospital Organization, Osaka Minami Medical Center, 2-1 Kidohigashi, Kawachinagano, Osaka, 586-8521, Japan. MLD03108@nifty.com
authors: Hiroyasu
authors: H
authors: Fujiwara
authors: Takashi
authors: T
authors: Kaito
authors: Takahiro
authors: T
authors: Makino
authors: Kazuo
authors: K
authors: Yonenobu
mesh_terms: D000368:Aged; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D001268:Atlanto-Axial Joint / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D002531:Cerebellum / Q000098:blood supply / Q000473:pathology*; D002544:Cerebral Infarction / Q000175:diagnosis* / Q000209:etiology; D003937:Diagnosis, Differential; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis / Q000503:physiopathology; D018810:Magnetic Resonance Angiography; D008297:Male; D013123:Spinal Fusion; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014711:Vertebral Artery / Q000473:pathology*; D014715:Vertebrobasilar Insufficiency / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery