Related Experiment Videos
[A case of effective decompression at the first segment of the vertebral artery for intractable vertigo]
K Igarashi1, T Sohma, K Kuwahara
1Department of Neurosurgery, Sapporo City General Hospital.
Insights
Mechanical compression of the vertebral artery by the stellate ganglion can cause recurrent vertigo. Surgical decompression effectively resolved intractable vertigo in a patient, highlighting this as a crucial treatment consideration.
Area of Science:
- Neurology
- Vascular Surgery
- Neurosurgery
Background:
- Vertebrobasilar insufficiency is primarily caused by atherosclerotic changes.
- Transient, recurrent vertigo with head movement suggests mechanical compression of the vertebral artery.
Observation:
- A 54-year-old male presented with recurrent vertigo triggered by head rotation.
- Medical treatment was ineffective prior to hospital admission.
- Diagnostic vertebral angiograms revealed compression of the right vertebral artery.
Findings:
- The right vertebral artery was compressed by the stellate ganglion.
- Surgical decompression involved detaching the stellate ganglion from the vertebral artery.
- The patient's vertigo resolved immediately after the procedure.
Implications:
- Recurrent vertigo under specific conditions warrants bilateral vertebral angiography to assess for mechanical compression.
- Surgical decompression is an effective treatment for vertigo caused by vertebral artery compression.
- This case underscores the importance of considering mechanical causes for vertebrobasilar insufficiency symptoms.
Abstract:
Atherosclerotic change is the main reason for vertebrobasilar insufficiency. However, if clinical symptoms such as vertigo happen transiently and repeatedly with head movement, vascular insufficiency due to mechanical compression of the vertebral artery must be kept in mind as its cause. The patient was a 54-year-old male complaining of recurrent vertigo which occurred during head rotation. He had been treated medically before he came to our hospital. Right compressed vertebral angiogram with head turned to the right and left compressed vertebral angiogram with head turned to the left were obtained at the first segment. Unilateral decompression of the vertebral artery was performed. At surgery it was found that the right vertebral artery was compressed by a stellate ganglion. After cutting of the sympathetic chains, the stellate ganglion was detached from the vertebral artery. The patient's intractable vertigo immediately disappeared after this procedure. It is concluded that if severe vertigo or dizziness is repeated under certain conditions, we must perform a bilateral vertebral angiogram and differentiate whether it is a case of decompression or not and then take measures to bring about decompression effectively.