Complete resolution of radiculopathy due to cervical vertebral artery dissection after intravascular treatment: a case report

The authors report the case of a rare manifestation by vertebral artery dissection. A 15-year-old boy who presented with left shoulder weakness and numbness of the left arm was admitted to our hospital. Neurological examination on admission revealed muscle weakness of the left deltoid muscle and sensory disturbance of the left C5 area. MRI/MRA and 3D-CT angiography demonstrated an aneurysm-like dilatation of the left vertebral artery mainly at the C4/5 level. Partial thrombosis was noted in the dilated artery. The left vertebral angiogram showed that the second and third portions of the left vertebral artery had a dilated pseudo-lumen due to arterial dissection. The pseudo-lumen of the dissected vertebral artery was largest in diameter at the C4/5 level. The patient successfully underwent proximal occlusion of the dissected vertebral artery using detachable balloon and Guglielmi detachable coils. Proximal vertebral artery occlusion using an intravascular technique was regarded as a non-invasive and effective option for patients with a cervical radiculopathy due to cervical vertebral artery dissection.