Medulla Compression by Bilateral Aberrant Vertebral Artery With Mild Chiari Malformation

A 48-year-old woman developed progressive right lower extremity numbness and lancinating pain of right pharynx. T2-weighted MRI revealed a flow-void area that corresponded to the both aberrant vertebral arteries (persistent first intersegmental arteries) severely compressing and distorting the medulla oblongata and tonsilar herniation consistent with a mild Chiari malformation. Mild hydrocephalus was also noted with thinning of the corpus callosum and partial empty sella (figure).

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