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Vertebral artery decompression in a patient with rotational occlusion

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Summary

We report a patient who suffered drop attacks during head reclination. Computer tomography of the cervical spine demonstrated a stenotic right vertebral artery at C4/5. However, Doppler ultrasonography of the vertebral artery showed no abnormality. Angiography confirmed complete occlusion of the left vertebral and a stenosis of the right vertebral artery. Dynamic angiography indicated occlusion of the stenotic region on the right side during reclination of the head. Surgery using a posterior approach with decompression of the vertebral artery, lead to an excellent outcome and the patient left the hospital without any symptoms. Therefore, in patients with drop attacks and normal ultrasonography, a stenosis of the vertebral artery caused by a spondylophytic compression could still be the cause. At worst, the stenosis could lead to brain infarction if left untreated. Dynamic angiography is crucial for the diagnosis and surgical decompression has excellent results.

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References

  • L Bakay EV Leslie (1965) ArticleTitleSurgical treatment of vertebral artery insufficiency caused by cervical spondylosis J Neurosurg 23 596–602 Occurrence Handle5861143 Occurrence Handle1:STN:280:DyaF28%2FptV2jtg%3D%3D Occurrence Handle10.3171/jns.1965.23.6.0596

    Article  PubMed  CAS  Google Scholar 

  • H Barth G Lang (1987) ArticleTitleDie Behandlung der zervikalen spondylogenen Insuffizienz der Arteria vertebralis Z Klin Med 42 1587–1590

    Google Scholar 

  • RJ Budway HJ Senter (1993) ArticleTitleCervical disc rupture causing vertebrobasilar insufficiency Neurosurgery 33 745–747 Occurrence Handle7901796 Occurrence Handle10.1097/00006123-199310000-00029 Occurrence Handle1:STN:280:DyaK2c%2FltVCltg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • JS Citow RL MacDonald (1999) ArticleTitlePosterior decompression of the vertebral artery narrowed by cervical osteophyte: case report Surg Neurol 51 495–499 Occurrence Handle10321878 Occurrence Handle10.1016/S0090-3019(98)00121-9 Occurrence Handle1:STN:280:DyaK1M3ltlOqtw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • FG Diaz JI Ausman C Shrontz J Pearce R Gehring B Mehta M Dujovny (1986) ArticleTitleSurgical correction of lesions affecting the second portion of the vertebral artery Neurosurgery 19 93–100 Occurrence Handle3748345 Occurrence Handle10.1097/00006123-198607000-00014 Occurrence Handle1:STN:280:DyaL28zhtFOhtw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • NA Ebraheim J Lu JA Brown A Biyani RA Yeasting (1996) ArticleTitleVulnerability of vertebral artery in anterolateral decompression for cervical spondylosis Clin Orthop 322 146–151 Occurrence Handle8542690

    PubMed  Google Scholar 

  • MW Fox DG Piepgras JD Bartleson (1995) ArticleTitleAnterolateral decompression of the atlantoaxial vertebral artery for symptomatic positional occlusion of the vertebral artery: case report J Neurosurg 83 737–740 Occurrence Handle7674027 Occurrence Handle1:STN:280:DyaK2MvgsVeiuw%3D%3D

    PubMed  CAS  Google Scholar 

  • TA Kuether GM Nesbit WM Clark SL Barnwell (1997) ArticleTitleRotational vertebral artery occlusion: a mechanism of vertebrobasilar insufficiency Neurosurgery 41 427–433 Occurrence Handle9257311 Occurrence Handle10.1097/00006123-199708000-00019 Occurrence Handle1:STN:280:DyaK2svgtFGntw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • T Mapstone RF Spetzler (1982) ArticleTitleVertebrobasilar insufficiency secondary to vertebral artery occlusion from a fibrous band: case report J Neurosurg 56 581–583 Occurrence Handle7062131 Occurrence Handle1:STN:280:DyaL387ksVOqtA%3D%3D

    PubMed  CAS  Google Scholar 

  • C Nagashima (1970) ArticleTitleSurgical treatment of vertebral artery insufficiency caused by cervical spondylosis J Neurosurg 32 512–521 Occurrence Handle5438093 Occurrence Handle1:STN:280:DyaE3c7lslOksw%3D%3D

    PubMed  CAS  Google Scholar 

  • M Ogino T Kawamoto K Asakuno Y Maeda P Kim (2001) ArticleTitleProper management of the rotational vertebral artery occlusion secondary to spondylosis Clin Neurol Neurosurg 103 250–253 Occurrence Handle11714574 Occurrence Handle10.1016/S0303-8467(01)00168-8 Occurrence Handle1:STN:280:DC%2BD3MnmvVyjtg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • E Pasztor (1978) ArticleTitleDecompression of vertebral artery in cases of cervical spondylosis Surg Neurol 9 371–377 Occurrence Handle675497 Occurrence Handle1:STN:280:DyaE1c3ivFSmug%3D%3D

    PubMed  CAS  Google Scholar 

  • RF Spetzler MN Hadley NA Martin LN Hopkins LP Carter J Budny (1987) ArticleTitleVertebrobasilar insufficiency. Part 1: Microsurgical treatment extracranial vertebrobasilar disease J Neurosurg 66 648–661 Occurrence Handle3553453 Occurrence Handle1:STN:280:DyaL2s7pslGlsg%3D%3D

    PubMed  CAS  Google Scholar 

  • MD Vilela R Goodkin DA Lundin DW Newell (2005) ArticleTitleRotational vertebrobasilar ischaemia: haemodynamic assessment and surgical management Neurosurgery 56 36–45 Occurrence Handle15617584

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery, University of Schleswig Holstein, Kiel, Germany

    A. K. Petridis, H. Barth, R. Buhl & H. M. Mehdorn

Authors
  1. A. K. Petridis
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  2. H. Barth
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  3. R. Buhl
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  4. H. M. Mehdorn
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Corresponding author

Correspondence to A. K. Petridis.

Additional information

Correspondence: Athanasios K. Petridis, M.D., Department of Neurosurgery, University of Schleswig Holstein, Campus Kiel, Schittenhelmstr. 10, 24105 Kiel, Germany.

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Petridis, A., Barth, H., Buhl, R. et al. Vertebral artery decompression in a patient with rotational occlusion. Acta Neurochir (Wien) 150, 391–394 (2008). https://doi.org/10.1007/s00701-008-1502-4

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  • DOI: https://doi.org/10.1007/s00701-008-1502-4

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