PMC6442480_01
Preoperative cervical magnetic resonance image (MRI) demonstrated multilevel cervical disc with myelopathy C3-C4, C4-C5, C5-C6.
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T2 high signal intensity changes (Figure 1). The patient examination was normal except for cervical muscle spasm and tenderness.
Normal finding postoperative brain CT.
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Urgent brain and cervical CT was done (Figure 2); no abnormality was detected in brain and cervical spine.
Brain and cervical CT Angiography (3rd day Post Op) revealed bilateral thalamic with upper brainstem ischemic infarction, with total occlusion of right vertebral artery from its origin and patent bilateral carotid artery with a normal flow.
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On the 3rd day, CT brain and angiography revealed a bilateral thalamic with upper brainstem ischemic infarction (Figure 3), with total occlusion of Rt vertebral artery from its origin and normal flow in both carotid arteries.
Brain and cervical MRI (after 2 weeks) show bilateral thalamic infarction with no compression on the spinal cord.
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After 2 weeks, brain and cervical MRI showed a bilateral thalamic infarction with no compression on the spinal cord (Figure 4).
Brain and cervical CT Angiography (after 3 months) revealed a bilateral hypodense area in the site of both thalami with no recanalization of right vertebral artery.
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At 3 months of follow-up, CT Angiography revealed a bilateral hypodense area in both thalami with no recanalization of right vertebral artery (Figure 5).