Proper management of the rotational vertebral artery occlusion secondary to spondylosis

Ogino, Masao; Kawamoto, Toshiki; Asakuno, Keizo; Maeda, Yoko; Kim, Phyo

doi:10.1016/s0303-8467(01)00168-8

Cited by 29 publications

(16 citation statements)

References 12 publications

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“…Cervical spondylosis with osteophyte formation, adjacent hypertrophic ligamentous and fibrous tissue elements, and tumorous lesion, which are potential causes for VA compression, can cause VA occlusion on head rotation and may contribute to the etiology of bow hunter's syndrome. 1,8,11,13,14,17,21) In the present case, presurgical neuroimaging study suggested no bony structures other than osseous protrusion in the right foramen transversarium at C5 which might have contributed to the rotational VA obstruction. Spondylotic change was not significant in the cervical spine.…”

Section: Discussionmentioning

confidence: 46%

Simultaneous Bilateral Vertebral Artery Occlusion in the Lower Cervical Spine Manifesting as Bow Hunter's Syndrome -Case Report-

Tsutsumi

Ito

Yasumoto

2008

Neurol. Med. Chir.(Tokyo)

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A 59-year-old male had suffered near-syncopal episodes for more than one year that occurred immediately on turning his head to the left. Cerebral magnetic resonance (MR) imaging did not detect any contributing lesions with well-developed posterior communicating arteries. Dynamic radiography of the cervical spine showed mild instability at C5-6 and concomitant intramedullary hyperintensity confirmed by T 2 -weighted MR imaging. Cervical computed tomography demonstrated an osseous protrusion in the right foramen transversarium at C5. Dynamic cerebral angiography revealed simultaneous vertebral artery (VA) occlusion at C6 on the right and C5 on the left associated with leftward head rotation. The VA showed an intact course at the C1 to C2 levels. The patient underwent anterior fusion followed by decompressive foraminotomy at C5-6 and C6-7 and meticulous resection of the markedly thickened fibroligamentous structure which was considered to contribute to the rotational VA occlusion. Postoperatively he no longer suffered near-syncope during head rotation. Bow hunter's syndrome is an infrequent type of vertebrobasilar insufficiency that may need surgical management for potential threat of ischemic stroke. Simultaneous VA occlusion at the lower cervical level can cause bow hunter's syndrome. Dynamic cerebral angiography is a useful modality for evaluating bow hunter's syndrome even if the patient cannot tolerate dynamic examination for the immediate symptom. Accurate anatomical knowledge of the uncovertebral foraminal region combined with intraoperative dynamic study is essential for safe surgery to the VA and favorable outcome.

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Section: Discussionmentioning

confidence: 46%

Simultaneous Bilateral Vertebral Artery Occlusion in the Lower Cervical Spine Manifesting as Bow Hunter's Syndrome -Case Report-

Tsutsumi

Ito

Yasumoto

2008

Neurol. Med. Chir.(Tokyo)

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“…7 Till now, very few cases presenting with vertigo and syncope resulting from vascular risk factors, cervical spondylosis, and head rotation have been reported in the literature. 9,10,11,12 Our patient presented with single episode of syncope followed by recurrent episodes of vertigo aggravated by head rotation to the right side. Patient also had multiple vascular risk factors like obesity, dyslipidemia, smoking and hypertension.…”

Section: Discussionmentioning

confidence: 87%

Syncope: A rare presentation of Cervical spondylosis

Verma¹,

Yaseen²,

Bharadwaj³

et al. 2014

IOSRJDMS

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“…Management of cervical vertigo is challenging because the source of symptoms is difficult to identify (88).If vertigo originates from proprioceptive dysfunc-tion of the upper cervical spine, it was suggested that the management of this condition should be the same as for cervical pain (13). Humphreys and Peterson (89) compared adult neck pain patients with dizziness (n=177) to neck pain patients without dizziness (n =228) who presented for chiropractic treatment.…”

Section: Treatmentmentioning

confidence: 99%

“…Several authors have that proposed manual therapy is effective for vertigo of a cervical origin (5,(17)(18)(19)88,90). We systematically reviewed the literature on manual therapy for the patients with cervicogenic dizziness, by evaluating RCTs published in English literature (see Table 2 for selected characteristics of these studies).…”

Section: Treatmentmentioning

confidence: 99%