Kimmerle anomaly surgeries at Semashko Hospital are neurosurgical interventions for decompression of the vertebral arteries that began to be performed at the N. A. Semashko Nizhny Novgorod Regional Clinical Hospital in September 2026. Before that, such operations had not been performed in Nizhny Novgorod. Until 2026, Nizhny Novgorod doctors referred patients with Kimmerle anomaly to federal medical centers for surgery — the region had no practice of its own in performing such interventions.[1][2]
Nature of the Intervention
Kimmerle anomaly is a structural feature of the first cervical vertebra in which additional bony structures (so-called bony bridges) compress the vertebral arteries at the point where they pass toward the base of the skull. Because the vertebral arteries take part in supplying blood to the brain, their pronounced compression disrupts blood flow and raises the risk of ischemic stroke in the vertebrobasilar territory. The anomaly can be either congenital or acquired.[2] The goal of the operation is to free the arteries from compression by removing the bony structures.[2]
The intervention is performed under high magnification using a surgical microscope. During the operation, the surgical microscope is set to its maximum, 25x magnification; work directly on the bony structures is carried out with microinstruments, and the bony bridge is cut away with a neurosurgical drill.[1] Highest-category neurosurgeon and deputy head of the neurosurgery department at the N. A. Semashko Regional Clinical Hospital Pyotr Cheremukhin described it as "practically a jeweler's operation": the work is done directly on the major vessels of the brain, and the slightest damage to a vertebral artery threatens severe bleeding or stroke. The intervention requires microvascular surgery skills and a high degree of precision.[2]
The First Patients
One of the first patients was a young woman born in 2006 who had suffered since childhood from headaches, unstable blood pressure, dizziness when turning her head, and episodes of loss of consciousness. Examination revealed bilateral compression of the vertebral arteries by bony bridges. Cheremukhin isolated the vessels and removed the compressing bony structures on both sides, completely freeing both arteries. Within a week after the operation the patient was discharged from the hospital; at a follow-up appointment several weeks later she reported that the headaches had gone and the dizzy spells had stopped.[2]
The second patient described was a 60-year-old man in whom a bony structure compressed one vertebral artery. After surgical treatment, his symptoms also disappeared. As of the end of September 2026, Pyotr Cheremukhin had performed four such operations; several more patients with the same pathology were undergoing examination and preparation for surgical treatment. All four vertebral artery decompression operations carried out at the Semashko Hospital in 2026 were successful.[1][2]
Diagnosis and Conditions for Introduction
The key tool for detecting the anomaly is CT angiography, which makes it possible to visualize the vessels and the surrounding bony structures at the same time, including determining whether the vertebral arteries are compressed. Cheremukhin recommended paying attention to the condition of the vessels of the neck and brain in cases of chronic headaches and dizziness, especially when they occur on turning the head.[2]
The introduction of these operations became possible under the national project "Long and Active Life," through which the hospital received the modern equipment needed to perform complex neurosurgical interventions.[2]
Sources
- GTRK "Nizhny Novgorod" (Vesti) — Until 2026, Nizhny Novgorod doctors referred patients with Kimmerle anomaly to federal medical centers for surgery — there was no local experience with such interventions
- Vremya N — The Semashko Regional Hospital has begun performing neurosurgical operations to decompress the vertebral arteries