|Title : Case 582|
Age / Sex : 17 / M
What is your impression?
Answer: right vertebral artery dissection, cerebellar infarction caused by Os odontoideum
Loss of flow void artifact of right vertebral artery, showing T2 high SI, due to vertebral artery insufficiency.
High SI lesion on DW and low SI on ADC showing vermis infarction
Os odontoideum presenting as atlantoaxial instability may cause symptomatic cord compression; thus, posterior fusion for stabilization is recommended in some cases. Roentogenographically, the presence of translation instability of 10 mm or
more between the atlas and the axis is considered an indication for fusion if the spinal cord symptoms are progressive.
Five cases of os odontoideum associated with pediatric cerebellar infarction have been reported.
Singer et al proposed that repeated subluxation of the atlas on axis may produce kinking, compression, stretching, and
tearing of the intima of the vertebral arteries leading to thromboembolic vertebrobasilar occlusions.
Atlantoaxial instability may cause mechanical stress to the vertebral artery as well as spinal cord injury. More
attention should be paid to the possible relation between atlantoaxial instability and vertebrobasilar artery insufficiency.
SPINE 2000;25(9): 1178–1181
|Total applicants||38||Correct answers||25|
|장용석||고려대학교 구로병원, 전문의|