Corkill G, French B N, Michas C, Cobb C A, Mims T J
Surg Neurol. 1977 Mar;7(3):109-15.
Two patients with previous brain stem infarction and current symptoms of vascular insufficiency in the basilar circulation had evidence of vertebral artery occlusive disease. Angiography demonstrated ostial stenosis of the dominant right vertebral artery and retrograde flow down the left vertebral artery to the level of the transverse process of C2 in the first case and to the level of a severely stenosed origin in the second case. Carotid circulation was patent in both cases. The blood flow in the posterior circulation was patent in both cases. The blood flow in the posterior circulation was augumented by extracranial anastomosis of the external carotid artery to the vertebral artery in the foramen transversarium at the level of C1-2 by a lateral approach in Case 1 and at the level of C4-5 by an anterior approach in Case 2. Postoperative improvement in neurologic status occurred in both cases.
两名既往有脑干梗死且目前有基底动脉循环血管功能不全症状的患者有椎动脉闭塞性疾病的证据。血管造影显示，在第一例中，优势右侧椎动脉开口处狭窄，左侧椎动脉有逆行血流至C2横突水平；在第二例中，逆行血流至严重狭窄的起始处水平。两例患者的颈动脉循环均通畅。两例患者后循环的血流均通畅。在病例1中，通过外侧入路在C1-2水平经横突孔将颈外动脉与椎动脉进行颅外吻合，在病例2中，通过前路在C4-5水平进行同样的吻合，后循环血流得以增加。两例患者术后神经状态均有改善。
