Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

A case of brainstem and cerebellar infarctions related to basilar impression

Takashi Kasai, M.D., Kenji Yoshikawa M.D., Shunji Tachibana, M.D., Takuya Taniguchi, M.D. and Masanori Nakagawa, M.D.

Department of Neurology, Kyoto Prefectural University of Medicine

We report a 30-year-old man presenting with medial longitudinal fasciculus (MLF) syndrome after an afternoon nap. Magnetic resonance imaging revealed a right medial pontine tegmental infarction and right cerebellar infarctions. This patient was complicated with basilar impression detected on cervical X-ray and MRI. Three-dimensional CT angiography disclosed that the odontoid process migrated into the posterior fossa, thrusting the bilateral vertebral arteries postero-laterally. The mechanical stress on the bilateral vertebral arteries may have caused infarctions in the territories of the posterior circulation of this patient with basilar impression.

(CLINICA NEUROL, 44: 203|206, 2004)
key words: basilar impression, brainstem and cerebellar infarctions

(Received: 29-Aug-03)