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

Jung Hoon Kang; Soo Bin Im; Je Hoon Jeong; Dong-Seong Shin

doi:10.7461/jcen.2019.21.3.158

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

J Cerebrovasc Endovasc Neurosurg. 2019 Sep;21(3):158-162. doi: 10.7461/jcen.2019.21.3.158. Epub 2019 Sep 30.

Authors

Jung Hoon Kang¹, Soo Bin Im¹, Je Hoon Jeong¹, Dong-Seong Shin¹

Affiliation

¹ Depertment of Neurosurgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea.

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.

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

Publication types

Case Reports