Positional vertebral artery compression and vertebrobasilar insufficiency due to a herniated cervical disc.
The authors report a case of vertebrobasilar insufficiency caused by vertebral artery (VA) compression due to a herniated cervical disc, which was surgically treated with the aid of intraoperative angiography. This 78-year-old man visited the hospital because of syncope following head rotation. Admission CT scans revealed a calcified mass adjacent to the right lateral process of the C-4 spine. Cervical angiography demonstrated an obstruction of the right VA at this region on rotation of the head to the right. The operation revealed a cervical disc protruding toward the right VA. The disc was surgically removed, and then the decompression of the right VA was confirmed on intraoperative angiography studies. A histopathological examination showed fibrohyaline cartilage, indicating an ossified intervertebral disc. The postoperative course was uneventful, and he has not experienced any syncope since treatment. A cervical disc herniation could be a cause of vertebrobasilar insufficiency by exerting positional compression of the VA. Intraoperative angiography could be quite useful to confirm this condition during decompression surgery for a cervical VA.
Ujifuku
Kenta
K
Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. kujifuku-nag@umin.ac.jp
Hayashi
Kentaro
K
Tsunoda
Keishi
K
Kitagawa
Naoki
N
Hayashi
Tomayoshi
T
Suyama
Kazuhiko
K
Nagata
Izumi
I
D000368:Aged; D002574:Cervical Vertebrae; D019416:Head Movements; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications* / Q000473:pathology* / Q000601:surgery; D008297:Male; D014715:Vertebrobasilar Insufficiency / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy