Nakamura K, Saku Y, Torigoe R, Ibayashi S, Fujishima M
Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Neuroradiology. 1998 Mar;40(3):164-6. doi: 10.1007/s002340050560.
We present a diagnostically challenging case of vertebrobasilar insufficiency caused by head rotation. The patient was a 58-year-old man complaining of dizziness and faintness with head rotation to the left. Vertebral arteriography with the head turned to the left revealed mechanical compression of the right vertebral artery at the occipitoatlantal joints and an occluded left vertebral artery. Duplex sonography demonstrated disappearance of the end-diastolic flow signal in the right vertebral artery on head rotation, paralleling the appearance of symptoms. Decompression of the vertebral artery by transversectomy of the atlas and hemilaminectomy of the axis completely relieved the symptoms and the Doppler flow signal pattern of the vertebral artery returned to normal: End-diastolic flow in the right vertebral artery did not disappear even when the head was rotated to the left.
我们报告一例因头部旋转导致椎基底动脉供血不足的具有诊断挑战性的病例。患者为一名58岁男性，主诉向左转头时出现头晕和昏厥。头部向左转动时的椎动脉造影显示，右侧椎动脉在枕寰关节处受到机械性压迫，左侧椎动脉闭塞。双功超声检查显示，头部旋转时右侧椎动脉舒张期末血流信号消失，与症状出现相符。通过寰椎横突切除术和枢椎半椎板切除术对椎动脉进行减压后，症状完全缓解，椎动脉的多普勒血流信号模式恢复正常：即使头部向左旋转，右侧椎动脉的舒张期末血流也不会消失。
