Foramen arcuale and syndrome of Barre-Lieou. Its surgical treatment.

At the point where the vertebral artery crosses the posterior arch of the atlas it may sometimes be enclosed by a bridge of bone, the so-called foramen arcuale. The foramen limits the normal mobility of the vessel during flexion and extension of the neck and may cause disturbances of arterial flow and of the peri-arterial sympathetic plexus giving rise to symptoms similar to those found in the Barre-Lieou syndrome. The authors describes the angiographic findings in such patients and a technique for the surgical excision of the foramen. The results of the operation in two groups of patients, with and without associated spondylosis of the lower cervical spine, are presented.