Document Detail

Proper management of the rotational vertebral artery occlusion secondary to spondylosis.
MedLine Citation:
PMID:  11714574     Owner:  NLM     Status:  MEDLINE    
A 66-year-old man with cervical spondylosis noticed severe vertigo when turning his head to the right. He underwent subclavian arteriography elsewhere, which showed a block of the contrast medium in the right vertebral artery (VA) at the C5/6 level when the patient turned his head to the right. After referral to our institute, however, postcontrast CT scan revealed an attenuated shadow of the venous plexus around the right VA at the C3/4 level. Repeated selective angiography with rotation of the head after visualization of the entire VA verified the level of obstruction to be at C3/4. Resection of the C4 transverse process through an anterior approach with drilling of the C3/4 spondylotic spur of the uncinate processi completely resolved the arterial impingement and the symptom. When evaluating rotational VA occlusion, dynamic angiography with selective catheterization is essential in determining which level is affected. The postcontrast CT scan is also useful because it suggests the level even without head rotation.
M Ogino; T Kawamoto; K Asakuno; Y Maeda; P Kim
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Clinical neurology and neurosurgery     Volume:  103     ISSN:  0303-8467     ISO Abbreviation:  Clin Neurol Neurosurg     Publication Date:  2001 Dec 
Date Detail:
Created Date:  2001-11-20     Completed Date:  2002-02-26     Revised Date:  2009-10-14    
Medline Journal Info:
Nlm Unique ID:  7502039     Medline TA:  Clin Neurol Neurosurg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  250-3     Citation Subset:  IM    
Department of Neurosurgery, Dokkyo University School of Medicine, 880 Kitakobayashi, Mibu, Shimotsuga, 321-0293, Tochigi, Japan.
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MeSH Terms
Cervical Vertebrae / blood supply*
Spinal Osteophytosis / complications*,  radiography
Tomography, X-Ray Computed
Treatment Outcome
Vertebral Artery / pathology*
Vertebrobasilar Insufficiency / etiology*,  physiopathology
Vertigo / etiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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