A Case of Basilar Impression

A case of basilar impression surgically treated in a female patient aged 22 years is presented. A myriad of abnormal neurologic findings were present that were secondary to compression of neural tissue by anormalous bony structure at craniovertebral junction. Metrizamide computerized tomography with coronal and sagittal reconstruction identified bony abnomalities and displacement of the surrounding neural structures. The surgical intervention for the treatment of the basilar impression consisted of ventral decompression by transoral odontoidectomy and of dorsal decompression by an enlargement of foramen magnum and by laminectomy of C1, followed by occipito-atlanto-axial bony fusion.

A Case bilateral Persistent Primitive Trigeminal Artery Combined with Cerebral Rete Mirabile

A man with bilateral primitive persistent trigeminal artery combined with cerebral rete mirabile is reported. Direct both common carotid artery angiogram is described with a brief discussion of the embryogenesis of carotid-basilar anastomosis and cerebral rete mirabile. Associated findings of previously reported cases of persistent trigeminal artery and cerebral rete mirabile are briefly reviewed. Persistent of the bilateral trigeminal artery associated with hemorrhage from cerebral rete mirabile seems worthy of notation. The angiographic findings were as follows; 1) The characteristic angiographic findings are bilateral occlusion at the cavernous portion of internal carotid artery. 2) Retrograde filling of middle cerebral artery from the collateral anastomotic channel was showed. 3) Anterior and posterior cerebral arteries are filled from leptomeningeal anastomotic channel and cerebral rete anastomosis. Authors suggested that the persistent trigeminal artery is congenital origin and cerebral rete mirabile may suspect to the secondary change.