Recurrent Embolic Strokes Associated with Vertical Atlantoaxial Subluxation in a Patient with Rheumatoid Arthritis: A Case Report and Review of Literature

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• 作者：Takuma Kuroki ; Yuji Ueno ; Ikuko Takeda ; Taiki Kambe ; Kenya Nishioka ; Hideki Shimura ; Masanori Itoh ; Nobutaka Hattori ; Takao Urabe
• 关键词：Atlantoaxial subluxation ; recurrent embolic stroke ; angiography ; carotid duplex ultrasonography
• 刊名：Journal of Stroke and Cerebrovascular Diseases
• 出版年：November, 2013
• 年：2013
• 卷：22
• 期：8
• 页码：e676-e681
• 全文大小：1382 K

文摘

We report a 78-year-old woman with rheumatoid arthritis who developed recurrent embolic cerebellar strokes associated with vertical atlantoaxial subluxation (AAS). On contrast angiography, the bilateral vertebral arteries (VAs) were occluded between the C1 and C2 levels, and the distal parts of bilateral VA were supplied by the collateral circulations. Dynamic cerebral angiography and carotid duplex ultrasonography showed that blood flow was substantially decreased in the left VA and left posterior inferior cerebellar artery on cervical anteflexion. It is suggested that vertical AAS reduced the blood flow of collateral circulation in the left VA with cervical anteflexion and might be a cause of recurrent ischemic stroke.