Bacterial meningitis caused by abscess between atlas posterior arch and occipital bone

Neurology and Clinical Neuroscience ◽

10.1111/ncn3.12530 ◽

2021 ◽

Author(s):

Tatsuya Ueno ◽

Shuya Ochiai ◽

Rena Okudera ◽

Akira Arai ◽

Masahiko Tomiyama

Keyword(s):

Bacterial Meningitis ◽

Occipital Bone ◽

Posterior Arch

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Rotational vertebral artery occlusion from occipital bone anomaly: a rare cause of embolic stroke

Journal of Neurosurgery ◽

10.3171/jns.2002.97.6.1456 ◽

2002 ◽

Vol 97 (6) ◽

pp. 1456-1459 ◽

Cited By ~ 32

Author(s):

Teiji Tominaga ◽

Toshiyuki Takahashi ◽

Hiroaki Shimizu ◽

Takashi Yoshimoto

Keyword(s):

Vertebral Artery ◽

Three Dimensional ◽

Craniovertebral Junction ◽

Artery Occlusion ◽

Occipital Bone ◽

Atlantoaxial Instability ◽

Posterior Arch ◽

Content Type ◽

The Right ◽

Fine Print

✓ Vertebral artery (VA) occlusion by rotation of the head is uncommon, but can result from mechanical compression of the artery, trauma, or atlantoaxial instability. Occipital bone anomalies rarely cause rotational VA occlusion, and patients with nontraumatic intermittent occlusion of the VA usually present with compromised vertebrobasilar flow. A 34-year-old man suffered three embolic strokes in the vertebrobasilar system within 2 months. Magnetic resonance imaging demonstrated multiple infarcts in the vertebrobasilar territory. Angiography performed immediately after the third attack displayed an embolus in the right posterior cerebral artery. Radiographic and three-dimensional computerized tomography bone images exhibited an anomalous osseous process of the occipital bone projecting to the posterior arch of the atlas. Dynamic angiography indicated complete occlusion of the left VA between the osseous process and the posterior arch while the patient's head was turned to the right. Surgical decompression of the VA resulted in complete resolution of rotational occlusion of the artery. An occipital bone anomaly can cause rotational VA occlusion at the craniovertebral junction in patients who present with repeated embolic strokes resulting from injury to the arterial wall.

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