Tortuous vertebral artery triggering vertebral foramen expansion and radiculopathy in a 19-year-old patient: a case report.

BACKGROUND: Arterial tortuosity is a widespread condition commonly occurring in cerebral arteries and often associated with the elderly. Moderate arterial tortuosity is often not symptomatic, but if there is severe tortuosity, various symptoms may occur, depending on the localization. In the literature, many factors have been reported as causing tortuosity in the vertebral arteries. In this case report, considering the age of our patient, we propose that, in addition to these previously reported reasons, congenital factors may also contribute to this situation. CASE PRESENTATION: We present a case of a 19-year-old Turkish patient with a tortuous vertebral artery causing pain and tingling in the right shoulder and neck. Magnetic resonance imaging revealed vertebral foramen enlargement thought to be secondary to a loop formation in the vertebral artery. The diagnosis was confirmed by magnetic resonance angiography. CONCLUSIONS: There are many causes of cervical radiculopathy. Arterial tortuosity, a rare cause of radiculopathy, should be considered as a differential diagnosis. Consideration of the existence of this variation is of great importance in preventing possible dangerous complications during surgery.

Accessory occipital suture mimicking fracture in head trauma.

The occipital bone is a complex structure due to its anatomy and accessory sutures. Fracture - accessory suture differential diagnosis should be performed carefully in patients with a history of head trauma [4]. In this case report we wanted to emphasize that accessory sutures can be difficult to diagnose in patients with head trauma. We also specified the points to be considered in the suture - fracture differentional diagnosis. A bilateral, symmetrical fissure line was observed in the occipital bone basal part of the patient who was admitted to our emergency department due to head trauma. The patient was followed up with accessory suture and then discharged after paying attention to important points in the differential diagnosis.