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.
KojimaN, , TamakiN, , FujitaK, & MatsumotoS: Vertebral artery occlusion at the narrowed “scalenovertebral angle”: mechanical vertebral occlusion in the distal first portion. Neurosurgery16:672–674, 1985
KojimaN, TamakiN, FujitaK, MatsumotoS: Vertebral artery occlusion at the narrowed “scalenovertebral angle”: mechanical vertebral occlusion in the distal first portion. Neurosurgery16:672–674, 1985)| false