VERTEBRAL ARTERY DISSECTION RELATED TO BASILAR IMPRESSION - CASE-REPORT

A 50-YEAR-OLD MAN with myelopathy secondary to basilar impression deve loped bilateral vertebral artery dissection after undergoing treatment with 8 pounds of cervical traction. The vertebral artery dissection r esulted in vertebrobasilar insufficiency and posterior circulation str oke, In this report, the current management philosophies in the treatm ent of basilar impression are discussed, and the pertinent neurovascul ar anatomy is illustrated. This report suggests that vertebral artery injury may result from attempted reduction of severe basilar impressio n. Regardless of the cause of cranial settling, the risk of vertebral artery injury with cervical traction should be considered in patients with severe basilar impression.