I thank Allan Fox for his comments and agree that the CT slice published with my earlier letter1 does not show the calcified right vertebral artery. Rather, it shows calcification in the sellar area. Although the CT image selected for publication did not show the right vertebral artery, the reporting radiologist clearly identified calcification of this vessel in a different slice (Fig. 1). Because of space limitations, only one slice, showing both calcification and the infarct, was selected for publication. Unfortunately, the wrong caption was included with the image, for which I sincerely apologize.
I also agree that the calcium deposit was an epiphenomenon that did not cause the stroke. However, I did not claim that the calcium deposit was the culprit. Rather, I merely speculated that occlusion of the right vertebral vessels caused by abnormal positioning of the neck during a prolonged telephone conversation probably led to thrombosis in the vertebral vessels, which in turn led to embolization of the clot and ultimately the pontine stroke.
Malvinder S. Parmar Medical Director, Medical Program (Internal Medicine) Timmins and District Hospital Timmins, Ont.
Reference
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