Dominant vertebral artery injury during posterior atlantoaxial transarticular screw fixation in a juvenile rheumatoid arthritis patient with atlantoaxial subluxation.

摘要: Many authors have reported on iatrogenic vertebral artery (VA) injury, but, to our knowledge, this is the first report of a dominant VA injury with compensatory blood flow from hypoplastic VA. A 23-year-old woman juvenile rheumatoid arthritis and atlantoaxial subluxation sustained her after occipitocervical fusion using transarticular screws. This did not result in lethal consequences due compensation contralateral Postoperative angiography, however, illustrated occlusion left side, while right side was enlarged. The patient experienced vertigo loss consciousness several times during rehabilitation. At 4-year follow-up exam, bony observed, no neurological deficits or correction loss. She had episodes unconsciousness recurrence any symptoms over previous 3 years.