Parthasarathy Rajsrinivas, Derksen Carol, Saqqur Maher, Khan Khurshid
Department of Neurointerventional Surgery, Institute of Neurosciences, Medanta - The Medicity, Gurgaon, Haryana, India.
Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
J Neurosci Rural Pract. 2016 Jan-Mar;7(1):161-3. doi: 10.4103/0976-3147.165430.
Embryonic carotid - basilar anastomosis when persistent in adult life can present with a variety of neurological symptoms. We present a patient with isolated intermittent vertigo attributable to the embryonic anastomosis and describe the different types of persistent trigeminal artery. A 76-year-old Caucasian man presented with isolated intermittent vertigo and symptoms suggestive of anterior and posterior circulation strokes. Impaired vasomotor reactivity was demonstrated on insonation of the anterior and posterior cerebral arteries in this patient with a persistent left trigeminal artery and 75% stenosis of the left internal carotid artery (ICA). The symptom of intermittent vertigo resolved with carotid endarterectomy. Decreased flow across the stenotic segment of the ICA which subserved the posterior circulation resulted in basilar insufficiency. Hypoperfusion to the flocculonodular lobe supplied by the anterior inferior cerebellar artery is a likely cause for the intermittent vertigo.
胚胎期的颈-基底吻合在成人期持续存在时可出现多种神经症状。我们报告一例因胚胎期吻合导致孤立性间歇性眩晕的患者，并描述持续性三叉动脉的不同类型。一名76岁的白种男性出现孤立性间歇性眩晕及提示前后循环卒中的症状。在这名患有持续性左侧三叉动脉且左侧颈内动脉（ICA）狭窄75%的患者中，经超声检查发现其大脑前动脉和大脑后动脉的血管运动反应受损。间歇性眩晕症状经颈动脉内膜切除术得以缓解。通过ICA狭窄段供应后循环的血流减少导致基底动脉供血不足。由小脑前下动脉供应的绒球小结叶灌注不足可能是间歇性眩晕的原因。
