颈椎病导致的旋转性椎动脉供血不足：病例报告及文献综述
Rotational vertebral artery insufficiency resulting from cervical spondylosis: case report and review of the literature.
作者信息
Bulsara Ketan R, Velez Dennis A, Villavicencio Alan
机构信息
Skull Base and Cerebrovascular Surgery, Division of Neurosurgery, University of Missouri-Columbia, Columbia, MO 65212, USA.
出版信息
Surg Neurol. 2006 Jun;65(6):625-7. doi: 10.1016/j.surneu.2005.08.016.
BACKGROUND
Four cases of vertebrobasilar insufficiency secondary to osteophyte formation at C5-C6 have been reported in the literature. In this article, we report the fifth such case and discuss the utility of dynamic computed tomographic angiography (CTA) in the management of this disorder.
CASE DESCRIPTION
A 55-year-old right-handed man presented for evaluation after syncopal episodes associated with right-head turning. Workup revealed cervical spondylosis with stenosis. The C5-C6 level was significantly affected. Dynamic angiography revealed obstruction of vertebral artery flow with right-head turning secondary to an osteophyte at the foramen transversarium at C5-C6. This patient underwent a C5-C6 anterior cervical discectomy and fusion. He also underwent unroofing of the vertebral artery and drilling of the osteophyte at the foramen transversarium. Postoperative CTAs reveal reconstitution of flow in the vertebral artery with head turning.
CONCLUSION
The utility of dynamic 3-dimensional CTA in the management of this disorder avoids the risk of invasive studies.
背景
文献中已报道了4例因C5 - C6椎体骨质增生继发椎基底动脉供血不足的病例。在本文中，我们报告第5例此类病例，并讨论动态计算机断层血管造影（CTA）在该疾病治疗中的应用。
病例描述
一名55岁右利手男性在出现与向右侧转头相关的晕厥发作后前来评估。检查发现颈椎骨质增生伴狭窄。C5 - C6水平受影响显著。动态血管造影显示，向右侧转头时椎动脉血流因C5 - C6横突孔处的骨质增生而受阻。该患者接受了C5 - C6颈椎前路椎间盘切除融合术。他还接受了椎动脉减压及横突孔骨质增生钻孔术。术后CTA显示转头时椎动脉血流重建。
结论
动态三维CTA在该疾病治疗中的应用避免了侵入性检查的风险。
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