Dynamic Vertebral Artery Compression by Solitary Osteochondroma Presenting with Recurrent Posterior Circulation Strokes

Soliman Oushy, Michelle J Clarke, Luis E. Savastano, Waleed Brinjikji, James P. Klaas

Research output: Contribution to journalArticlepeer-review

Abstract

A 24-year-old male presented with recurrent posterior circulation strokes over 3 years despite aspirin and anticoagulation use. A comprehensive stroke workup was negative. Review of initial imaging revealed an exophytic left C1 lateral mass bony overgrowth posterior to the vertebral artery (VA) (Figure [B] and [C]). Angiography revealed a chronic traumatic dissection at the level of C1-2 foramen in an otherwise patient left VA. Angiography with right head turn showed complete occlusion of the left VA caused by extrinsic compression from the C1 lesion (Figure [D] through [F]; Video S1). He underwent surgical resection of a pathologically proven osteochondroma (Figure [F]). Postoperative dynamic imaging confirmed resolution of VA compromise and he remained asymptomatic over 3-months of follow-up. Osteochondroma-induced VA compromise is exceedingly rare.1 Dynamic extrinsic VA compression can be missed on noninvasive imaging.

Original languageEnglish (US)
Pages (from-to)E379-E380
JournalStroke
Volume53
Issue number8
DOIs
StatePublished - Aug 1 2022

Keywords

  • compression
  • dissection
  • osteochondroma
  • stroke
  • vertebral artery

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

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