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Vertebrobasilar insufficiency

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https://www.readbyqxmd.com/read/28450231/bow-hunter-s-syndrome-surgical-management-video-and-review-of-the-literature
#1
Ben A Strickland, Martin H Pham, Joshua Bakhsheshian, Jonathan J Russin, William J Mack, Frank L Acosta
BACKGROUND: Bow Hunter's Syndrome (BHS) is a rare condition characterized by vertebrobasilar insufficiency associated with rotational vertebral artery occlusion during head movement. Many existing reports describe surgical management, though no single technique has proven superior. OBJECTIVE: To review all reported cases of BHS with focus on outcomes of individual techniques as well as present a video report of a posterior decompression without fusion performed at the authors' institution...
April 24, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28434468/the-effect-of-chinese-herbal-medicine-banxia-baizhu-tianma-decoction-for-the-treatment-of-vertebrobasilar-insufficiency-vertigo-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#2
REVIEW
ZhenLang Guo, ZhenNing Su, ZhengFei Wang, XiaoMu Luo, RenKui Lai
OBJECTIVES: Banxia Baizhu Tianma Decoction (BBTD) is widely used to treat vertebrobasilar insufficiency vertigo (VBIV) in China, but its efficacy remains largely unexplored. We systemically summarized relevant evidence from randomized controlled trials (RCTs) to assess the therapeutic effect of BBTD. METHODS: Seven electronic databases were searched for relevant electronic studies published before July 2016. We evaluated RCTs that compared BBTD, anti-vertigo drugs and a combination of BBTD and anti-vertigo drugs...
April 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/28262395/lateral-and-posterolateral-foraminal-variations-of-the-atlas-a-meta-analysis
#3
Przemysław A Pękala, Brandon Michael Henry, Jakub R Pękala, Karolina Saganiak, Dominik Taterra, Jerzy A Walocha, R Shane Tubbs, Krzysztof A Tomaszewski
The lateral (LF) and posterolateral (PLF) foramina are anatomical variants of the atlas. Both variants have been implicated in multiple neurological conditions including vertebrobasilar insufficiency, with symptoms such as dizziness, syncope, auditory and visual disturbances and paresis. The aim of this study was to conduct a systematic meta-analysis on the prevalence and anatomical characteristics of the LF and PLF. An extensive search of the major electronic databases was conducted to identify all studies that reported relevant data on the LF and PLF...
March 2, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28117210/cryptic-recanalization-of-chronic-vertebral-artery-occlusion-by-head-rotation
#4
Kenji Yagi, Hiroshi Nakagawa, Hideo Mure, Shinya Okita, Shinji Nagahiro
BACKGROUND: Chronic vertebral artery occlusion (VAO) can be associated with ischemic stroke, as thrombi formed under blood flow stagnation around the stump of the VAO may migrate into the brain. We report a new mechanism of chronic VAO-associated ischemic stroke and a patient with cryptic recanalization of chronic VAO by head rotation. CASE DESCRIPTION: A 74-year-old man presented with chronic right VAO and repeated ischemic embolic stroke in the posterior circulation despite antiplatelet therapy...
January 20, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28007277/random-finding-of-a-ruptured-kommerell-aneurysm-after%C3%A2-stroke
#5
Iannis Ben Abdallah, Salma El Batti, Pierre Julia, Jean-Marc Alsac
The random finding of a ruptured Kommerell aneurysm (rKA) is exceptional. We report the case of a 74-year-old man who received an incidental diagnosis of a contained rKA involving an aberrant right subclavian artery after a stroke. He underwent successful hybrid repair with the use of thoracic endovascular aortic repair associated with cervical debranching of the left subclavian artery and vascular plug occlusion of both subclavian artery origins. Whereas no early adverse event was reported, the patient experienced a vertebrobasilar insufficiency once he had recovered, requiring an additional right carotid-to-subclavian bypass...
January 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27903481/hybrid-repair-of-complex-left-subclavian-artery-injury-with-partial-transection-and-complete-thrombosis-in-an-unstable-patient-following-blunt-trauma
#6
Ilitch Diaz-Gutierrez, Muhammad A Rana, Barkat Ali, John M Marek, Mark Langsfeld
Blunt subclavian artery injuries are rare and are associated with high morbidity and mortality. Several case reports have suggested that endovascular repair is safe with short operative times and minimal blood loss. We report a case of a 20-year-old male patient involved in a high-speed motor vehicle collision that resulted in partial transection of left subclavian artery with complete luminal thrombosis. Patient also had a left main-stem bronchus avulsion along with major intra-abdominal injuries and multiple spine and long bone fractures...
November 27, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27799374/where-did-the-clot-go-an-unusual-complication-of-mechanical-thrombectomy-caused-by-malignancy-related-subclavian-steal-phenomenon-in-a-patient-with-acute-basilar-artery-occlusion
#7
Nikkie Randhawa, Jonathan P Squires, Manraj Kanwal Singh Heran, Sharanpal K Mann
Subclavian steal is a relatively common vascular phenomenon usually caused by atherosclerotic disease. While symptoms are rare, arm claudication of the ipsilateral limb is most common, with paroxysmal symptoms of vertebrobasilar insufficiency (often exercise induced) being relatively uncommon. Here we present a case of brachial artery embolism during mechanical thrombectomy for basilar artery thrombosis, secondary to subclavian steal phenomenon. This atypical and potentially irreversible complication should be considered in patients with acute ischemic stroke undergoing neurointerventional management when subclavian steal is discovered angiographically...
October 31, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27798325/dynact-angiography-for-the-diagnosis-of-bilateral-bow-hunter-s-syndrome
#8
Tony Lu, Ponraj Chinnadurai, Javier E Anaya-Ayala, Orlando M Diaz
We herein present a rare case of bilateral positional vertebrobasilar insufficiency secondary to mechanical obstruction of the V2 segment of the vertebral artery in a 71-year-old patient presenting with vertigo, occipital headache, tremors and respiratory irregularities. Two-dimensional digital subtraction angiography is the traditional diagnostic imaging standard but does not capture any peri-vascular bony or soft tissue abnormalities that are important to understand the three-dimensional pathophysiology. Intra-procedural cone-beam computed tomography (CT) is an increasingly used diagnostic adjunct, available in most modern angiographic suites that allows for the three-dimensional visualization of the vasculature as well as CT-like soft tissue visualization of its surrounding anatomy...
February 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27797875/where-did-the-clot-go-an-unusual-complication-of-mechanical-thrombectomy-caused-by-malignancy-related-subclavian-steal-phenomenon-in-a-patient-with-acute-basilar-artery-occlusion
#9
Nikkie Randhawa, Jonathan P Squires, Manraj Kanwal Singh Heran, Sharanpal K Mann
Subclavian steal is a relatively common vascular phenomenon usually caused by atherosclerotic disease. While symptoms are rare, arm claudication of the ipsilateral limb is most common, with paroxysmal symptoms of vertebrobasilar insufficiency (often exercise induced) being relatively uncommon. Here we present a case of brachial artery embolism during mechanical thrombectomy for basilar artery thrombosis, secondary to subclavian steal phenomenon. This atypical and potentially irreversible complication should be considered in patients with acute ischemic stroke undergoing neurointerventional management when subclavian steal is discovered angiographically...
October 25, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27716015/rotational-vertebrobasilar-insufficiency-due-to-compression-of-a-persistent-first-intersegmental-vertebral-artery-variant-case-report
#10
Vivek P Buch, Peter J Madsen, Kerry A Vaughan, Paul F Koch, David K Kung, Ali K Ozturk
Rotational vertebrobasilar insufficiency, or bow hunter's syndrome, is a rare cause of posterior circulation ischemia, which, following rotation of the head, results in episodic vertigo, dizziness, nystagmus, or syncope. While typically caused by dynamic occlusion of the vertebral artery in its V2 and V3 segments, the authors here describe a patient with dynamic occlusion of the vertebral artery secondary to a persistent first intersegmental artery, a rare variant course of the vertebral artery. In this case the vertebral artery coursed under rather than over the posterior arch of the C-1...
February 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27610119/advances-in-the-pathogenesis-diagnosis-and-treatment-of-bow-hunter-s-syndrome-a-comprehensive-review-of-the-literature
#11
REVIEW
Guangxin Duan, Jiaping Xu, Jijun Shi, Yongjun Cao
Bow hunter's syndrome (BHS), also known as rotational vertebral artery (VA) occlusion syndrome, is a rare yet treatable type of symptomatic vertebrobasilar insufficiency resulting from mechanical occlusion or stenosis of the VA during head and neck rotation or extension. The symptoms of BHS range from transient vertigo to posterior circulation stroke. The underlying pathology is dynamic stenosis or compression of the VA by abnormal bony structures with neck rotation or extension in many cases, such as osteophyte, disc herniation, cervical spondylosis, tendinous bands or tumors...
June 2016: Interventional Neurology
https://www.readbyqxmd.com/read/27609452/bilateral-subaxial-rotational-vertebral-artery-occlusion-in-a-setting-of-a-prior-cervical-construct
#12
Daniel R Felbaum, Joshua E Ryan, Andrew B Stemer, Amjad N Anaizi
BACKGROUND: Rotational vertebral artery occlusion, or bow hunter's syndrome, most commonly affects the C1-2 level because of its importance in regulating rotational movement. CASE DESCRIPTION: A 50-year-old man with increasing neck pain and severe symptoms of vertebrobasilar insufficiency with bidirectional head rotation had undergone several prior subaxial cervical spine operations. Dynamic cerebral angiography demonstrated complete occlusion of the left vertebral artery during head rotation to the right and complete occlusion of the right vertebral artery during head rotation to the left...
January 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27565589/resolution-of-ischemic-symptoms-after-percutaneous-angioplasty-for-a-symptomatic-subclavian-artery-stenosis
#13
Leszek Wrotniak, Anna Kabłak-Ziembicka, Agnieszka Rosławiecka, Piotr Musiałek, Paweł Bogacki, Mariusz Trystuła, Krzysztof Żmudka, Tadeusz Przewłocki
OBJECTIVE: A minor part of patients with subclavian or innominate artery occlusive disease (subclavian artery stenosis [SAS]) experience symptoms of vertebrobasilar insufficiency, upper extremity exertional ischemia (UEEI), or cardiac ischemia owing to subclavian-coronary steal (SCS) in some instances. The study aimed to assess the impact of percutaneous transluminal angioplasty (PTA) of symptomatic SAS on symptom resolution and to determine factors related with SAS recurrence. METHODS: Symptom resolution and incidence of restenosis (RS) were evaluated for up to 15 years in patients who had undergone successful PTA of SAS...
September 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27546696/vertebrobasilar-insufficiency-and-gamma-glutamyltransferase-an-emerging-relationship-demonstrating-inflammation-and-atherosclerosis
#14
M S Ulu, M Beker-Acay, S Ulu, E Unlu, A Bucak, G Yaman, A Altug, M S Tekin, S Oruc
OBJECTIVES: Vertebrobasilar insufficiency (VBI) is a pathology arising from the reduction in flow rate of vertebral arteries and mainly caused by inflammation and atherosclerosis. Gamma-glutamyltransferase (GGT) is a marker which has been recently recognized as a marker of inflammation and atherosclerosis. We aimed to investigate the relationship between GGT levels and VBI for the first time. METHODS: In this cross-sectional study, of 3100 subjects who had vertebrobasilar doppler ultrasonography (VBU) were evaluated and 1042 of them who met the inclusion criterias were included...
2016: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/27388018/vertebral-artery-loops-in-surgical-perspective
#15
Murat Şakir Ekşi, Zafer Orkun Toktaş, Baran Yılmaz, Mustafa Kemal Demir, Emel Ece Özcan-Ekşi, Ahmed B Bayoumi, Yasin Yener, Akın Akakın, Deniz Konya
PURPOSE: Vertebral artery loop is a congenital or acquired anomaly. Vertebral artery loops are incidentally diagnosed during evaluation of neck problems and trauma. We aimed to present the incidence of VA loops using magnetic resonance angiography in consecutive patients and discuss epidemiological data including the gender, age, location, signs and symptoms, treatment approaches and outcomes of VA loops via analyzing literature. METHODS: In the first leg of our two-legged study, consecutive patients were evaluated using magnetic resonance angiography to detect any medial loop of vertebral arteries...
July 7, 2016: European Spine Journal
https://www.readbyqxmd.com/read/27367654/relevance-of-the-pharmacokinetic-and-pharmacodynamic-profiles-of-puerariae-lobatae-radix-to-aggregation-of-multi-component-molecules-in-aqueous-decoctions
#16
Bili Su, Yongjun Kan, Jianwei Xie, Juan Hu, Wensheng Pang
The complexity of traditional Chinese medicines (TCMs) is related to their multi-component system. TCM aqueous decoction is a common clinical oral formulation. Between molecules in solution, there exist intermolecular strong interactions to form chemical bonds or weak non-bonding interactions such as hydrogen bonds and Van der Waals forces, which hold molecules together to form "molecular aggregates". Taking the TCM Puerariae lobatae Radix (Gegen) as an example, we explored four Gegen decoctions of different concentration of 0...
June 28, 2016: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/27195937/association-of-sudden-sensorineural-hearing-loss-with-vertebrobasilar-insufficiency
#17
Yin-Hsuan Hsu, Hsiao-Yun Hu, Yu-Chwen Chiu, Fei-Peng Lee, Hung-Meng Huang
IMPORTANCE: Little is known about the association between sudden sensorineural hearing loss (SSNHL) and vertebrobasilar insufficiency (VBI). OBJECTIVE: To explore the association between SSNHL and VBI. DESIGN, SETTING, AND PARTICIPANTS: This investigation was a population-based, case-control study. Patients from January 1, 2000, to December 31, 2011, were retrospectively identified from the Taiwan National Health Insurance Research Database, which includes claims data on a random sample of 1 million people...
July 1, 2016: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/27041076/combined-use-of-intraoperative-indocyanine-green-and-dynamic-angiography-in-rotational-vertebral-artery-occlusion
#18
Nauman S Chaudhry, Sudheer Ambekar, Mohamed Samy Elhammady, Jonathan P Riley, Gustavo Pradilla, Raul G Nogueira, Faiz U Ahmad
Rotational vertebral artery occlusion, also known as bow hunter's syndrome, is a well-documented surgically amenable cause of vertebrobasilar insufficiency. Traditionally, patients have been imaged using dynamic rotational angiography. The authors sought to determine whether intraoperative indocyanine green (ICG) angiography could reliably assess the adequacy of surgical decompression of the vertebral artery (VA). The authors report two patients who presented with multiple transient episodes of syncope provoked by turning their head to the right...
August 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/26811743/an-anatomical-study-of-arcuate-foramen-and-its-clinical-implications-a-case-report
#19
Salman Afsharpour, Kathryn T Hoiriis, R Bruce Fox, Samuel Demons
BACKGROUND: The objective of this paper is to describe the relationship of the vertebral artery (VA) to the Atlas (C1) in the sub-occipital region in the presence of arcuate foramen; and discuss the clinical implications related to manual therapies and surgical implications related to screw placement. This study is an anatomical cadaveric case report of symmetrical bilateral lateral and dorsal arcuate foramina on the C1 dorsal arch. CASE PRESENTATION: Out of 40 cadavers that were available for use in teaching anatomy in the university setting, three presented with anomalies of the C1 dorsal arch...
2016: Chiropractic & Manual Therapies
https://www.readbyqxmd.com/read/26807367/are-there-any-novel-radiological-diagnostic-clues-in-magnetic-resonance-imaging-for-vertebrobasilar-insufficiency
#20
Emin Cakmakci, Safiye Tokgoz Ozal, Esra Karabay Ogutcu, Alper Aydin, Suzan Tunc, Umut Kaygusuz, Hasibe Gokce Cinar
BACKGROUND: The aim of the current study was to investigate whether signal intensities on magnetic resonance imaging (MRI) views and radiological findings on Doppler ultrasonography may have a diagnostic value for vertebrobasilar insufficiency (VBI). METHODS: This case-control study was performed on demographic and radiologic data derived from 18 VBI patients and 58 healthy controls in the radiology department of a tertiary care center. The blood flow characteristics including peak systolic and end diastolic flow rates, resistance and pulsatility indices, mean velocities, flow rates, diameters and intensity pattern of vertebral arteries on cervical and cranial MRI sequences were noted...
December 2015: Quantitative Imaging in Medicine and Surgery
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