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Symptomatic occipital-vertebral anastomosis - a case report
J Harada1, N Kuwayama, M Nishijima
1Department of Neurosurgery, Saiseikai Takaoka Hospital; Takaoka, Japan.
Summary
Symptomatic occipital-vertebral anastomosis (O-V anastomosis) is rare. This case highlights O-V anastomosis causing syncope and vertebrobasilar insufficiency due to vertebral steal phenomenon.
Area of Science:
- Vascular Neurology
- Cerebrovascular Anatomy
Background:
- Occipital-vertebral (O-V) anastomosis is a known collateral pathway.
- It connects the external carotid artery system to the vertebro-basilar system.
- Symptomatic presentations of O-V anastomosis are uncommon.
Purpose of the Study:
- To report a rare case of symptomatic O-V anastomosis.
- To investigate the cause of syncope and vertebrobasilar insufficiency in this patient.
Main Methods:
- Case report detailing clinical presentation.
- Review of relevant anatomical and physiological principles.
- Discussion of potential causative mechanisms.
Main Results:
- The patient presented with syncope and symptoms of vertebrobasilar insufficiency.
- An O-V anastomosis was identified as the likely cause.
- The vertebral steal phenomenon was implicated as the mechanism.
Conclusions:
- O-V anastomosis, though common anatomically, can rarely cause significant neurological symptoms.
- Vertebral steal phenomenon through O-V anastomosis can lead to transient ischemic attacks and syncope.
- Recognition of this rare collateral pathway is crucial for diagnosing such cases.
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