Skip to main content
Advertisement

Main menu

  • Home
  • Content
    • Current Issue
    • Publication Preview--Ahead of Print
    • Past Issue Archive
    • Case of the Week Archive
    • Classic Case Archive
    • Case of the Month Archive
    • COVID-19 Content and Resources
  • For Authors
  • About Us
    • About AJNR
    • Editors
    • American Society of Neuroradiology
  • Submit a Manuscript
  • Podcasts
    • Subscribe on iTunes
    • Subscribe on Stitcher
  • More
    • Subscribers
    • Permissions
    • Advertisers
    • Alerts
    • Feedback
  • Other Publications
    • ajnr

User menu

  • Subscribe
  • Alerts
  • Log in

Search

  • Advanced search
American Journal of Neuroradiology
American Journal of Neuroradiology

American Journal of Neuroradiology

  • Subscribe
  • Alerts
  • Log in

Advanced Search

  • Home
  • Content
    • Current Issue
    • Publication Preview--Ahead of Print
    • Past Issue Archive
    • Case of the Week Archive
    • Classic Case Archive
    • Case of the Month Archive
    • COVID-19 Content and Resources
  • For Authors
  • About Us
    • About AJNR
    • Editors
    • American Society of Neuroradiology
  • Submit a Manuscript
  • Podcasts
    • Subscribe on iTunes
    • Subscribe on Stitcher
  • More
    • Subscribers
    • Permissions
    • Advertisers
    • Alerts
    • Feedback
  • Follow AJNR on Twitter
  • Visit AJNR on Facebook
  • Follow AJNR on Instagram
  • Join AJNR on LinkedIn
  • RSS Feeds
LetterLetter

Fatal Ethibloc Embolization of Vertebrobasilar System Following Percutaneous Injection into Aneurysmal Bone Cyst of the Second Cervical Vertebra

Bernd Turowski, Frank Schellhammer, Jörg Herdmann and Frank Rommel
American Journal of Neuroradiology August 2005, 26 (7) 1883-1884;
Bernd Turowski
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Frank Schellhammer
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jörg Herdmann
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Frank Rommel
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
  • References
  • PDF
Loading

Peraud et al (1) reported a fatal injection of Ethibloc into an aneurysmatic bone cyst of C2 due to inadvertent embolization in the vertebrobasilar system. The embolization material was found in a small branch artery of the vertebral artery at the C2 level. The authors suspect that the embolizing material passed into a side branch of the vertebral artery running into the aneurysmatic bone cyst. Our own experience with intravertebral contrast injection supports this theory. Within the vertebroplasty of osteolytic lesions of C2, we routinely perform vertebral phlebography. The contrast is injected via the needle placed to inject the bone cement. The background for this routine is the experience that osseous pathology in vertical vertebral bodies often is supplied by arterial branches of the vertebral arteries. In one patient with an osteolytic lesion from breast cancer, we could prove a retrograde filling of the left vertebral artery and subsequently the basilar artery by injection of contrast into the osteolytic lesion of the second vertebra. We found an impressive amount of contrast filling the posterior circulation (Fig 1). Direct arterial puncture could be excluded by needle position.

Consequently, we did perform vertebroplasty under biplanar fluoroscopy by using a higher viscosity of the bone cement than normally used. The patient was treated successfully and without any complication.

Anatomically, the vertebral arteries supply the bone in the cervical spine. Under normal conditions, the selective angiography of the vertebral arteries cannot visualize the vertebral supply, but highly perfused bone tumors (eg, metastases) in the cervical spine show tumor blush via selective vertebral injection. We do think that enlargement of anatomically normal arterial vessels supplying the vertebral bone due to pathologic structures in the bone are the basis for functional relevant connections between the osseous structures of the cervical spine and the posterior arterial circulation. We suggest performing contrast injection before embolization or cement injection into cervical vertebral bodies, regardless of individual pathology. Furthermore, biplanar fluorscopic control may help to avoid inadvertent embolization of the basilar artery.

Fig 1.
  • Download figure
  • Open in new tab
  • Download powerpoint
Fig 1.

Anteroposterior (A) and lateral (B) views of contrast injection into C2. The arrows mark the needle and instruments of the surgical access, which normally is used at our institution to perform vertebroplasty of C2. There is an early filling of the left vertebral artery and the basilar artery via small arterial branches.

References

  1. ↵
    Peraud A, Drake JM, Armstrong D, et al. Fatal ethibloc embolization of vertebrobasilar system following percutaneous injection into aneurysmal bone cyst of the second cervical vertebra. AJNR Am J Neuroradiol 2004;25:1116–1120
    Abstract/FREE Full Text
  • Copyright © American Society of Neuroradiology
PreviousNext
Back to top

In this issue

American Journal of Neuroradiology: 26 (7)
American Journal of Neuroradiology
Vol. 26, Issue 7
1 Aug 2005
  • Table of Contents
  • Index by author
Advertisement
Print
Download PDF
Email Article

Thank you for your interest in spreading the word on American Journal of Neuroradiology.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Fatal Ethibloc Embolization of Vertebrobasilar System Following Percutaneous Injection into Aneurysmal Bone Cyst of the Second Cervical Vertebra
(Your Name) has sent you a message from American Journal of Neuroradiology
(Your Name) thought you would like to see the American Journal of Neuroradiology web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Fatal Ethibloc Embolization of Vertebrobasilar System Following Percutaneous Injection into Aneurysmal Bone Cyst of the Second Cervical Vertebra
Bernd Turowski, Frank Schellhammer, Jörg Herdmann, Frank Rommel
American Journal of Neuroradiology Aug 2005, 26 (7) 1883-1884;

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Fatal Ethibloc Embolization of Vertebrobasilar System Following Percutaneous Injection into Aneurysmal Bone Cyst of the Second Cervical Vertebra
Bernd Turowski, Frank Schellhammer, Jörg Herdmann, Frank Rommel
American Journal of Neuroradiology Aug 2005, 26 (7) 1883-1884;
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • References
  • Figures & Data
  • Info & Metrics
  • References
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • Primary Aneurysmal Bone Cyst of the Spine in Children: Updated Outcomes of a Modern Surgical Technique
  • Crossref
  • Google Scholar

This article has not yet been cited by articles in journals that are participating in Crossref Cited-by Linking.

More in this TOC Section

  • Fair Performance of CT in Diagnosing Unilateral Vocal Fold Paralysis
  • Reply:
  • Regarding “Altered Blood Flow in the Ophthalmic and Internal Carotid Arteries in Patients with Age-Related Macular Degeneration Measured Using Noncontrast MR Angiography at 7T”
Show more Letters

Similar Articles

Advertisement

News and Updates

  • Lucien Levy Best Research Article Award
  • Thanks to our 2022 Distinguished Reviewers
  • Press Releases

Resources

  • Evidence-Based Medicine Level Guide
  • How to Participate in a Tweet Chat
  • AJNR Podcast Archive
  • Ideas for Publicizing Your Research
  • Librarian Resources
  • Terms and Conditions

Opportunities

  • Share Your Art in Perspectives
  • Get Peer Review Credit from Publons
  • Moderate a Tweet Chat

American Society of Neuroradiology

  • Neurographics
  • ASNR Annual Meeting
  • Fellowship Portal
  • Position Statements

© 2023 by the American Society of Neuroradiology | Print ISSN: 0195-6108 Online ISSN: 1936-959X

Powered by HighWire