Tanaka H, Takahashi H, Ishijima B, Usui M
No Shinkei Geka. 1987 Mar;15(3):341-7.
A rare case with the episodes of vertebrobasilar TIAs which were caused by carotid ulcerative lesion and by persistence of proatlantal intersegmental artery is reported. This 69-year-old man was admitted on 14th Feb. 1985 with complaints of three attacks of vertigo, diplopia, nausea, vomiting and dysequilibrium lasting about 1 hour. His past history and family history were unremarkable. On admission, physical and neurological examinations revealed nothing particular, except bilateral carotid bruits. On the right side, innocent low pitched bruit was detected, however on the left side, carotid bruit was high pitched and was regarded as pathological. Blood pressure was 180/80 mmHg. Pulse rate was 66/min and cardiac arrhythmia was not detected by EKG. He also had no history of cardiac arrhythmia as mentioned above. CT scans and MRI showed only mild brain atrophy and no brain stem nor cerebellar lesions. Left carotid angiogram revealed ulcerative lesion of the common carotid bifurcation which was compatible with high pitched bruit. And at the level of the C2 vertebra, persistent proatlantal intersegmental artery originated from the left internal carotid artery which, after running upward, joined to the horizontal portion of the left vertebral artery above the atlas. Internal carotid and the vertebrobasilar vasculature beyond the proatlantal intersegmental artery were normal except slight irregularity of carotid siphon. Right carotid and vertebral angiograms revealed no abnormality and basilar artery was opacified clearly again via right vertebral artery.(ABSTRACT TRUNCATED AT 250 WORDS)
报告了一例罕见病例，其椎基底动脉短暂性脑缺血发作由颈动脉溃疡性病变和寰椎前节段间动脉持续存在引起。该69岁男性于1985年2月14日入院，主诉有三次眩晕、复视、恶心、呕吐及平衡失调发作，持续约1小时。他的既往史和家族史无异常。入院时，体格检查和神经系统检查未发现特殊情况，仅双侧颈动脉有杂音。右侧可闻及无害的低调杂音，而左侧颈动脉杂音为高调，被视为病理性杂音。血压为180/80 mmHg。脉搏率为66次/分钟，心电图未检测到心律失常。他也无上述心律失常病史。CT扫描和MRI仅显示轻度脑萎缩，未发现脑干及小脑病变。左侧颈动脉血管造影显示颈总动脉分叉处有溃疡性病变，与高调杂音相符。在C2椎体水平，寰椎前节段间动脉持续存在，起源于左颈内动脉，向上走行后在寰椎上方与左椎动脉水平段相连。除颈动脉虹吸部略有不规则外，寰椎前节段间动脉远端的颈内动脉和椎基底血管系统正常。右侧颈动脉和椎动脉血管造影未发现异常，基底动脉经右侧椎动脉再次清晰显影。（摘要截取自250字）
