RESUMO
Dual origin of the vertebral artery (VA) is an uncommon anatomical variation. We describe a case of duplication origin at right vertebral artery (RVA) found incidentally in one elderly patient on investigation for cerebral aneurysm. Angiogram study showed a pseudoaneurysm at V4 segment of the RVA associated with embryological anatomy. The authors performed a systematic review of the similar cases reported worldwide.
Assuntos
Variação Anatômica , Cefaleia/etiologia , Aneurisma Intracraniano/diagnóstico , Dissecação da Artéria Vertebral/diagnóstico , Artéria Vertebral/anormalidades , Angiografia Digital , Artéria Carótida Interna/diagnóstico por imagem , Feminino , Humanos , Aneurisma Intracraniano/complicações , Pessoa de Meia-Idade , Artéria Vertebral/lesões , Dissecação da Artéria Vertebral/etiologiaRESUMO
BACKGROUND: Brainstem abscess is a rare condition with a variety of treatment approaches. In this paper, we report an unusual case of a brainstem abscess with a positive outcome in an immunocompetent patient who was treated with antibiotic therapy. CASE DESCRIPTION: A 22-year-old female presented with bilateral tetraparesis that was worse on the left hemibody, appendicular tremor, and left upper eyelid ptosis. Brain magnetic resonance imaging showed an abscess in the pons and midbrain due to possible nocardiosis. She was treated with dexamethasone, phenytoin, vancomycin, and meropenem for 8 weeks and trimethoprim-sulfamethoxazole for 6 weeks. The brain injury decreased, and the patient's neurological status significantly improved. CONCLUSION: Brainstem abscess may be treated conservatively, leading to improvement of the clinical condition and decreased lesion size on imaging.