CPPD-related basilar impression with vertebral artery dissection and subsequent subarachnoid hemorrhage: illustrative case

This is the first reported case of VA dissection with posterior fossa hemorrhage secondary to basilar impression due to CPPD. Inflammatory arthritides of the CCJ may cause rapidly progressive atlantoaxial erosion, predisposing one to unstable basilar impression and VA dissection. Awareness of this risk is crucial in the surgical management of inflammatory basilar impression, where preoperative vascular imaging may be warranted in selected cases. https://thejns.org/doi/10.3171/CASE25332.