Vertebral artery loop formation causing cervical radiculopathy

Case contributed by Ayaz Hidayatov
Diagnosis almost certain

Presentation

Chronic neck pain radiating into the left arm.

Patient Data

Age: 30 years
Gender: Female
This study is a stack
Sagittal
T2
This study is a stack
Axial
T2
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Info

Sagittal T2WI and axial T2GRE images showed a signal-void vascular structure loops at the level C4-C5 neural foramina and compressing the left C5 nerve root.

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Info

The red arrow indicates the vascular loop at the level of left C4-5 intervertebral neural foramina.

Case Discussion

Vertebral artery loop formation (VALF) is an anatomic variation and uncommon cause of cervical radiculopathy caused by direct compression of the nerve root.

The mechanism of vertebral loop forms and migrates into the intervertebral foramen is unclear. The most common level of occurrence of a tortuous vertebral artery is C3-C4 and C4–C5. The most frequent side of occurrence is on the left.

Incorrect diagnosis of vertebral artery loop formation as disc herniation may lead to a possible injury to the vertebral artery during surgery.

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