Repeated basilar tip occlusion associated with atlantooccipital assimilation: A case report

J Stroke Cerebrovasc Dis. 2024 Dec;33(12):108080. doi: 10.1016/j.jstrokecerebrovasdis.2024.108080. Epub 2024 Oct 10.

Abstract

We describe an 82-year-old man with multiple cerebral infarctions due to vertebral artery dissection associated with an atlanto-occipital assimilation. Despite multiple thrombectomies and antithrombotic therapy changes, the patient developed thrombosis and recurrent infarction, due to mechanical damage to the vertebral artery possibly associated with abnormal cervical spine motion from atlanto-occipital assimilation. This case highlights the rare association between atlanto-occipital assimilation and stroke and the importance of considering structural abnormalities for stroke management.

Keywords: Atlanto-occipital assimilation; Mechanical thrombectomy; Parent artery embolization; Vertebral artery dissection.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Atlanto-Occipital Joint* / diagnostic imaging
  • Cerebral Infarction / diagnostic imaging
  • Cerebral Infarction / etiology
  • Computed Tomography Angiography
  • Fibrinolytic Agents / administration & dosage
  • Humans
  • Male
  • Recurrence
  • Thrombectomy
  • Treatment Outcome
  • Vertebral Artery Dissection* / complications
  • Vertebral Artery Dissection* / diagnostic imaging
  • Vertebral Artery Dissection* / etiology
  • Vertebrobasilar Insufficiency / complications
  • Vertebrobasilar Insufficiency / diagnostic imaging
  • Vertebrobasilar Insufficiency / etiology
  • Vertebrobasilar Insufficiency / physiopathology
  • Vertebrobasilar Insufficiency / therapy

Substances

  • Fibrinolytic Agents