Morikawa K, Ohkawa N, Yamashita S
Department of Neurosurgery, Hoshigaoka Koseinenkin Hospital.
No Shinkei Geka. 1993 Nov;21(11):1035-8.
A case of bilateral fenestration of the vertebral artery at the level of the atlas in a patient who had occipital neuralgia and cervical myelopathy is presented. MRI and vertebral angiogram demonstrated the fenestrated vertebral artery compressing the upper cervical cord. Surgical decompression for the C-1 and C-2 sensory roots and the upper cervical cord was performed. Fenestration of the vertebral artery is mostly of no clinical significance. However, considering the pathway of the fenestrated vertebral artery, it is quite possible that the fenestrated vertebral artery might compress the neural structures, resulting in some clinical problems. Although occipital neuralgia may result from a variety of causes, this case was caused by the fenestrated vertebral artery compressing the C-1 and C-2 sensory roots. The authors wish to emphasize that microsurgical vascular decompression may be the only effective treatment in such cases as well as in facial spasm and trigeminal neuralgia.
本文报告了一例患有枕神经痛和颈椎病的患者，其椎动脉在寰椎水平出现双侧开窗。MRI和椎动脉血管造影显示，开窗的椎动脉压迫颈上段脊髓。对C-1和C-2感觉神经根以及颈上段脊髓进行了手术减压。椎动脉开窗大多无临床意义。然而，考虑到开窗椎动脉的走行，开窗的椎动脉很可能会压迫神经结构，导致一些临床问题。虽然枕神经痛可能由多种原因引起，但该病例是由开窗的椎动脉压迫C-1和C-2感觉神经根所致。作者希望强调，显微外科血管减压术可能是此类病例以及面肌痉挛和三叉神经痛的唯一有效治疗方法。
