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1 Case introduction
The patient, a 50-year-old woman, was admitted to the Department
Past history: there is a history of recurrent neck and low back pain for more than
Admission examination: blood pressure 104/61 mmHg (1 mmHg = 133.
Initial diagnosis:
Cervical spinal cord disease?
Cerebrovascular disease?
Spinal disc herniation?
Complete the relevant examinations
After imaging analysis, the patient's cervical and lumbar spine MRI did not see the responsible lesions, combined with electromyography examination, considering that the patient's limb fatigue symptoms were not caused by
Further improvement of cranial MRI + MRA examination (2019-06-24) showed that vertebral artery shadows could be seen on the ventral side of the right medulla oblongata, corresponding to bulbar compression, the right medulla oblongata ventral T2WI suspected high signal, T1WI, DWI, FLAIR phase did not see obvious abnormalities
After admission, he was treated
Final diagnosis:
Vertebral artery bulbar compression syndrome
Lumbar disc herniation (bulging type)
2 Discussions
Verebral artery medulla compression syndrome (VAMCS) is a rare neurovascular disease that is directly related to compression of the spinal artery due to detours, dilation, etc.
According to foreign literature, the disease is more common in patients around 30 years old or over 60 years old, and most patients > 40 years old
In this case, the main symptoms of the patient are fatigue of the limbs with the right side of the eye
VAMCS is more common with unilateral lateral compression of the ventral lateral medulla oblongata, which can cause local compressive microvascular ischemic changes in
In 1985, Kim et al.
When Cierpiol et al.
At present, vertebral artery bulbar compression is mostly treated by microvascular surgery, including surgical options
VAMCS is a rare neurovascular disease, and the patient in this case presents with right-sided quadriplegia, which is easy to misdiagnose as cervical myelopathy or other neurovascular diseases, so detailed history collection, physical examination, and imaging are particularly important
