J Clin Neurol.  2015 Jul;11(3):292-294. 10.3988/jcn.2015.11.3.292.

Vertebral Artery Compression during Roll Tilt: Is the Edge of the Foramen Magnum a Culprit?

• Choi JY
• Seo WK
• Oh K
• Seo SI
• Ryou N
• Chae SW

• KMID: 1894574
• DOI: http://doi.org/10.3988/jcn.2015.11.3.292

Abstract

No abstract available.

MeSH Terms

Foramen Magnum*
Vertebral Artery*

Figure

• 

  Fig. 1 Findings of rotational vertebral-artery occlusion during roll tilt. A: Electronystagmography. Leftward head tilt evokes an initial right-beating nystagmus for 10 s, followed by 15 s of a null period and then left-beating nystagmus. There is no obvious vertical or torsional component. B: 3-D CT angiography. Total occlusion of the right vertebral artery and focal stenosis of the left vertebral artery (arrow) can be seen. The medial edge of the foramen magnum is spatially close to the stenotic left vertebral artery. C: Proximal left vertebral artery duplex ultrasonography. Leftward head tilt results in a reduction in peak systolic flow velocity from 60 to 40 cm/s (a 33% reduction). Rebound hyperemia can be seen while uprighting.

Reference

1. Strupp M, Planck JH, Arbusow V, Steiger HJ, Brückmann H, Brandt T. Rotational vertebral artery occlusion syndrome with vertigo due to "labyrinthine excitation". Neurology. 2000; 54:1376–1379.

2. Choi KD, Choi JH, Kim JS, Kim HJ, Kim MJ, Lee TH, et al. Rotational vertebral artery occlusion: mechanisms and long-term outcome. Stroke. 2013; 44:1817–1824.

3. Choi JH, Kim MJ, Lee TH, Moon IS, Choi KD, Kim JS. Dominant vertebral artery occlusion during ipsilateral head tilt. Neurology. 2011; 76:1679.