case_images: PMC6442480_01
case_images: Preoperative cervical magnetic resonance image (MRI) demonstrated multilevel cervical disc with myelopathy C3-C4, C4-C5, C5-C6.
case_images: CRINM2019-9438089.001.jpg
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case_images: fig1
case_images: T2 high signal intensity changes (Figure 1). The patient examination was normal except for cervical muscle spasm and tenderness.
case_images: Normal finding postoperative brain CT.
case_images: CRINM2019-9438089.002.jpg
case_images: PMC6442480_01_CRINM2019-9438089.002.jpg
case_images: fig2
case_images: Urgent brain and cervical CT was done (Figure 2); no abnormality was detected in brain and cervical spine.
case_images: 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.
case_images: CRINM2019-9438089.003.jpg
case_images: PMC6442480_01_CRINM2019-9438089.003.jpg
case_images: fig3
case_images: 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.
case_images: Brain and cervical MRI (after 2 weeks) show bilateral thalamic infarction with no compression on the spinal cord.
case_images: CRINM2019-9438089.004.jpg
case_images: PMC6442480_01_CRINM2019-9438089.004.jpg
case_images: fig4
case_images: After 2 weeks, brain and cervical MRI showed a bilateral thalamic infarction with no compression on the spinal cord (Figure 4).
case_images: 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.
case_images: CRINM2019-9438089.005.jpg
case_images: PMC6442480_01_CRINM2019-9438089.005.jpg
case_images: fig5
case_images: 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).