• Mahammed Zia Khansuheb, Evgueni Kouznetsov, Michael Manchak, Qasim Durrani, and Alexander Drofa.
• Department of Neurovascular Surgery, Sanford Medical Center Fargo, Fargo, North Dakota, USA; University of North Dakota, Grand Forks, North Dakota, USA.
• World Neurosurg. 2020 Feb 1; 134: 280-283.

BackgroundWe report a case of cervical radiculopathy caused by an anomalous vertebral artery (VA) and the efficacy of endovascular vertebral artery sacrifice.Case DescriptionA 62-year-old woman was referred to neurosurgery because of an 8- to 9-year history of progressive left C6-7 radiculopathy refractory to other forms of treatment. Radiologic evaluation showed an abnormally tortuous loop of VA at V2 causing direct neurovascular compression at the C6-7 level. Initial attempts at microvascular decompression with posterior foraminotomy were unsuccessful due to strong adhesion between the VA and C7 nerve root. This was followed by an endovascular VA sacrifice relieving the patient's symptoms.ConclusionsCervical root compression by an aberrant or anomalous extracranial VA is a rare cause of radiculopathy. Endovascular VA sacrifice provided symptom relief in our patient, when other options failed. To our knowledge, this is the first report of endovascular VA sacrifice for management of cervical radiculopathy due to VA loop.Copyright © 2019 Elsevier Inc. All rights reserved.

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