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Vertebrobasilar junction entrapment due to a clivus fracture is a rare clinical observation. The present case report describes a 54-yr-old man who sustained a major craniofacial injury. The patient displayed a stuporous mental state (Glasgow Coma Scale [GCS]=8) and left hemiparesis (Grade 3). The initial computed tomography (CT) scan revealed a right subdural hemorrhage in the frontotemporal region, with a midline shift and longitudinal clival fracture. A decompressive craniectomy with removal of the hematoma was performed. Two days after surgery, a follow-up CT scan showed cerebellar and brain stem infarction, and a CT angiogram revealed occlusion of the left vertebral artery and entrapment of vertebrobasilar junction by the clival fracture. A decompressive suboccipital craniectomy was performed and the patient gradually recovered. This appears to be a rare case of traumatic vertebrobasilar junction entrapment due to a longitudinal clival fracture, including a cerebellar infarction caused by a left vertebral artery occlusion. A literature review is provided.
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http://dx.doi.org/10.3346/jkms.2008.23.4.747 | DOI Listing |
Surg Radiol Anat
September 2025
Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 75 Mikras Asias Str., Goudi, 11527, Athens, Greece.
Purpose: To describe and analyze two rare cases of arterial rings at the vertebrobasilar junction (VBJ), likely representing persistent segments of the primitive lateral basilovertebral anastomosis (PLBVA), and to explore their embryological origin and clinical significance.
Materials And Methods: Two morphological arterial variants were identified during a retrospective review of computed tomography angiography (CTA) scans from 505 patients. Multiplanar reconstruction and three-dimensional volume rendering were used for anatomical characterization.
J Neurosurg Case Lessons
September 2025
Department of Neurosurgery, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, Jiangsu Province, China.
Background: Vertebrobasilar junction (VBJ) aneurysms are frequently associated with basilar artery variations like fenestration or hypoplasia, altering hemodynamics. An interrupted aortic arch (IAA), a rare congenital malformation, may contribute to intracranial aneurysms via vascular wall defects, hemodynamic stress, and compensatory hypertension. Coexistence of IAA with cerebrovascular anomalies and VBJ aneurysms is exceptionally rare, with no prior documented cases.
View Article and Find Full Text PDFLaryngoscope
August 2025
Northwell, New Hyde Park, NY, USA.
Endoscopic repair of reconstruction at the craniocervical junction is sparsely described and remains a rather challenging procedure. The presented case details a unique case of a left vertebrobasilar artery de novo aneurysm that was successfully treated via an expanded endonasal transclival approach with a rhinopharyngeal flap. The rhinopharyngeal flap aids in both exposure and reconstruction at the craniocervical junction.
View Article and Find Full Text PDFJ Neurointerv Surg
June 2025
Department of Interventional Neuroradiology and Neuroendovascular Surgery, Miami Neuroscience Institute and Miami Cardiac & Vascular Institute - Baptist Hospital, Miami, Florida, USA.
Introduction: Catheter-mediated (Dotter) angioplasty has been previously described for extracranial/peripheral arteries. Tenzing (Route 92 Medical, San Mateo, California, USA), a shelf-reducing delivery catheter, has an atraumatic tapered distal tip that progressively enlarges to maximal outer diameter of 1.2 mm (Tenzing 5), 1.
View Article and Find Full Text PDFJ Craniofac Surg
May 2025
Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens.
Intracranial arterial fenestrations are infrequent variants of the cerebral arterial circle, which generally occur due to incomplete embryological fusion during vascular development. These fenestrations hold clinical significance because of their association with modified hemodynamics and the potential for aneurysm formation. The present imaging report highlights a unique double intracranial fenestration incidentally identified during magnetic resonance angiography (MRA) of a 53-year-old female patient.
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