J Cerebrovasc Endovasc Neurosurg.  2019 Sep;21(3):158-162. 10.7461/jcen.2019.21.3.158.

Rotational vertebral artery syndrome treated via an anterior approach and selective decompression only

Affiliations
  • 1Depertment of Neurosurgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea. isbrzw@gmail.com

Abstract

We present the case of a 38-year-old male who complained of repeated dizziness and syncope. Rotational vertebral artery syndrome (RVAS) was diagnosed via videonystagmoraphy (VNG), computed tomography angiography (CTA) and three-position digital subtraction angiography (DSA). In the neutral position, CTA and DSA revealed left vertebral artery (VA) stenosis at the C2 transverse foramen and right VA hypoplasia. When the head was turned to the right, the blood flow stopped at the C2 level. The bony structure around the VA at the C2 transverse foramen was decompressed via an anterior surgical approach, and the symptoms resolved. This case present the precise stenotic point evaluation by three-position DSA is crucial for the planning of surgical treatment.

Keyword

Anterior decompression; Nystagmus; Posterior circulation infarction; Rotational vertebral artery syndrome; Videonystagmography

MeSH Terms

Adult
Angiography
Angiography, Digital Subtraction
Constriction, Pathologic
Decompression*
Dizziness
Head
Humans
Male
Syncope
Vertebral Artery*
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