LAUSR

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