Positional vertebral artery compression and vertebrobasilar insufficiency due to a herniated cervical disc

Case report

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  • 1 Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences; and
  • 2 Department of Pathology, Nagasaki University Hospital, Sakamoto, Nagasaki, Japan
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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.

Abbreviations used in this paper: VA = vertebral artery; VBI = vertebrobasilar insufficiency.

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Contributor Notes

Address correspondence to: Kenta Ujifuku, M.D., Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan. email: kujifuku-nag@umin.ac.jp.
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