Carotid to distal vertebral artery bypass for vertebrobasilar ischemia

1984 ◽  
Vol 60 (1) ◽  
pp. 187-189 ◽  
Author(s):  
Perry E. Camp
Keyword(s):  
Vertebral Artery ◽  
Simple Technique ◽  
Artery Bypass ◽  
Vertebrobasilar Insufficiency ◽  
Venous Graft ◽  
Content Type ◽  
Vertebrobasilar Ischemia ◽  
Extracranial Vertebral Artery ◽  
The Common ◽  
Collateral Vessels

✓ A simple technique is described for a venous graft between the common carotid artery and the extracranial vertebral artery. In the case described, the vertebral artery was shown angiographically to be occluded and reconstituted by collateral vessels. This patient had symptoms of vertebrobasilar insufficiency which resolved postoperatively.

Subclavian to distal vertebral artery bypass

1983 ◽  
Vol 58 (4) ◽  
pp. 607-610 ◽  
Author(s):  
Howard J. Senter ◽  
Edwin T. Long
Keyword(s):  
Vertebral Artery ◽  
Simple Technique ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Vertebrobasilar Insufficiency ◽  
Content Type ◽  
Vein Bypass ◽  
Extracranial Vertebral Artery ◽  
Fine Print

✓ A simple technique is described for extracranial vertebral artery vein bypass grafting, utilizing an internal shunt that avoids prohibitively dangerous vertebral artery cross-clamping. This procedure was carred out successfully in a patient with vertebrobasilar insufficiency.

Transient rotational compression of the vertebral artery caused by herniated cervical disc

2003 ◽  
Vol 98 (1) ◽  
pp. 80-83 ◽  
Author(s):  
Andrew N. Nemecek ◽  
David W. Newell ◽  
Robert Goodkin
Keyword(s):  
Vertebral Artery ◽  
Head Rotation ◽  
Cervical Disc ◽  
Vertebrobasilar Insufficiency ◽  
Content Type ◽  
Vertebrobasilar Ischemia ◽  
Extrinsic Compression ◽  
The Many ◽  
Herniated Cervical Disc ◽  
Adequate Decompression

✓ Of the many causes of vertebrobasilar insufficiency (VBI), extrinsic compression of the vertebral artery (VA) is relatively uncommon. A syndrome of VBI caused by extrinsic compression of the VA secondary to head rotation has been termed positional vertebrobasilar ischemia. The authors present a case of transient VBI caused by herniation of a cervical disc. Transcranial Doppler ultrasonography was used preoperatively to confirm the diagnosis and intraoperatively to monitor cerebral perfusion and to confirm that adequate decompression of the VA had been achieved.

Vertebrobasilar insufficiency secondary to vertebral artery occlusion from a fibrous band

1982 ◽  
Vol 56 (4) ◽  
pp. 581-583 ◽  
Author(s):  
Timothy Mapstone ◽  
Robert F. Spetzler
Keyword(s):  
Vertebral Artery ◽  
Artery Occlusion ◽  
Vertebrobasilar Insufficiency ◽  
Fibrous Band ◽  
Content Type ◽  
Vertebral Artery Occlusion ◽  
The Right ◽  
Band Crossing ◽  
Fine Print

✓ A case is described in which vertebral artery occlusion, caused by a fibrous band, occurred whenever the patient turned his head to the right side, resulting in vertigo and syncope whenever the head was turned to the right. Release of a fibrous band crossing the vertebral artery 2 cm from its origin relieved the patient's vertebral artery constriction and symptoms.

Rotational Vertebrobasilar Ischemia: Hemodynamic Assessment and Surgical Treatment

Neurosurgery ◽  
2005 ◽  
Vol 56 (1) ◽  
pp. 36-45 ◽  
Author(s):  
Marcelo D. Vilela ◽  
Robert Goodkin ◽  
David A. Lundin ◽  
David W. Newell
Keyword(s):  
Surgical Treatment ◽  
Vertebral Artery ◽  
Transcranial Doppler ◽  
Posterior Circulation ◽  
Long Term Results ◽  
Vertebrobasilar Insufficiency ◽  
Head Turning ◽  
Vertebrobasilar Ischemia ◽  
Hemodynamic Assessment ◽  
Vertebral Artery Compression

Abstract OBJECTIVE: Rotational vertebrobasilar insufficiency is a severe and incapacitating condition. Proper investigation and management are essential to reestablish normal posterior circulation hemodynamics, improve symptoms, and prevent stroke. We present a series of 10 patients with rotational vertebrobasilar ischemia who were treated surgically and emphasize the importance of transcranial Doppler in the diagnosis and management of this condition. METHODS: All patients presented with symptoms of vertebrobasilar insufficiency induced by head turning. Transcranial Doppler documented a significant decrease in the posterior cerebral artery velocities during head turning that correlated with the symptoms in all patients. A dynamic cerebral angiogram was performed to demonstrate the site and extent of vertebral artery compression. RESULTS: The surgical technique performed was tailored to each individual patient on the basis of the anatomic location, pathogenesis, and mechanism of the vertebral artery compression. Five patients underwent removal of osteophytes at the level of the subaxial cervical spine, one patient had a discectomy, two patients had a decompression only at the level of C1–C2, and two patients had a decompression and fusion at the C1–C2 level. CONCLUSION: The transcranial Doppler is extremely useful to document the altered hemodynamics preoperatively and verify the return of normal posterior circulation velocities after the surgical decompression in patients with rotational vertebrobasilar ischemia. Surgical treatment is very effective, and excellent long-term results can be expected in the vast majority of patients after decompression of the vertebral artery.

Pseudoaneurysm of the extracranial vertebral artery

1987 ◽  
Vol 67 (6) ◽  
pp. 935-939 ◽  
Author(s):  
Karl Detwiler ◽  
John C. Godersky ◽  
Lindell Gentry
Keyword(s):  
Soft Tissue ◽  
Vertebral Artery ◽  
Intracranial Aneurysms ◽  
Balloon Occlusion ◽  
Artery Pseudoaneurysm ◽  
Content Type ◽  
Unusual Association ◽  
Associated Symptoms ◽  
Extracranial Vertebral Artery ◽  
Fine Print

✓ The unusual association of a giant extracranial vertebral artery pseudoaneurysm, intracranial aneurysms, and extracranial carotid occlusion in a woman with neurofibromatosis is presented. Pain as a result of expansion of the mass in the soft tissue of the neck led to her seeking evaluation. Herniation of the mass intraspinally between the occiput and C-1 resulted in myelopathy. Following balloon occlusion of the vertebral artery, the mass and associated symptoms resolved without the need for direct resection. The salient features of these unusually associated problems are discussed.

Hemodynamic analysis of associated extracranial atraumatic vertebral artery aneurysm and arteriovenous fistula

1987 ◽  
Vol 67 (6) ◽  
pp. 940-943 ◽  
Author(s):  
Bruce Rosenblum ◽  
Stephanie Rifkinson-Mann ◽  
Michael Sacher ◽  
Rosemaria Gennuso ◽  
Allen Rothman
Keyword(s):  
Vertebral Artery ◽  
Arteriovenous Fistula ◽  
Artery Aneurysm ◽  
Content Type ◽  
Av Fistula ◽  
Extracranial Vertebral Artery ◽  
Fine Print

✓ A case of atraumatic arteriovenous (AV) fistula of the extracranial vertebral artery associated with an atraumatic aneurysm of the contralateral extracranial vertebral artery is reported. The fistulous lesion was excised after distal and proximal ligation of the vessel. Subsequently, the contralateral aneurysm underwent spontaneous dissolution. Seven cases of extracranial vertebral AV fistulae associated with ipsilateral vertebral artery aneurysms (four traumatic and three as part of vascular dysplastic syndromes) have been reported previously.

scholarly journals Surgical clip occlusion of the V3 segment to prevent recurrent cerebral infarction associated with extracranial vertebral artery dissection: A case report

2020 ◽  
Vol 11 ◽  
pp. 337
Author(s):  
Ryo Aiura ◽  
Masaki Matsumoto ◽  
Tohru Mizutani ◽  
Tatsuya Sugiyama ◽  
Daisuke Tanioka
Keyword(s):  
Cerebral Infarction ◽  
Vertebral Artery ◽  
Vertebral Artery Dissection ◽  
Artery Dissection ◽  
Parent Artery ◽  
Surgical Clip ◽  
Parent Artery Occlusion ◽  
Extracranial Vertebral Artery ◽  
Collateral Vessels ◽  
Clip Occlusion

Background: Recurrent cerebral infarction caused by traumatic extracranial vertebral artery dissection (EVAD) is treated medically and surgically. We report a case of EVAD that was treated using surgical clip occlusion of the V3 segment to prevent recurrent cerebral infarction. Case Description: A 48-year-old man was admitted for a cerebral infarction caused by EVAD and was treated using 200 mg/day cilostazol. Afterward, the cerebral infarction recurred. Digital subtraction angiography revealed that initial severe stenosis of the VA ostium resulted in the final occlusion and that collateral vessels to the VA remained. We continued antiplatelet therapy, but the cerebral infarction recurred due to thromboembolism of the collateral vessels. Parent artery occlusion was planned. We exposed the V3 segment of the VA and clipped it to prevent the recurrence of cerebral infarction. Conclusion: Surgical clip occlusion of the V3 segment was effective for treating recurrent cerebral infarction caused by traumatic EVAD that had remained an issue despite continuing medical therapy.

Microvascular anatomy of foramen caecum medullae oblongatae

1991 ◽  
Vol 75 (2) ◽  
pp. 299-304 ◽  
Author(s):  
Asim Mahmood ◽  
Manuel Dujovny ◽  
Maximo Torche ◽  
Ljubisa Dragovic ◽  
James I. Ausman
Keyword(s):  
Vertebral Artery ◽  
Basilar Artery ◽  
Foramen Magnum ◽  
Left Vertebral Artery ◽  
Anterior Inferior Cerebellar Artery ◽  
Outer Diameter ◽  
Vertebrobasilar Insufficiency ◽  
High Concentration ◽  
Content Type ◽  
Fine Print

✓ The foramen caecum (FC) is a triangular-shaped fossa situated in the midline on the base of the brain stem, at the pontomedullary junction. Although this area is known to have a very high concentration of brainstem perforating vessels, its microvascular anatomy has not been studied in detail. The purpose of this study was to detail the microvasculature of this territory. Twenty unfixed brains were injected with silicone rubber solution and dissected under a microscope equipped with a camera. The origin, course, outer diameter, and branching pattern of the perforators were examined. The total number of perforators found in the 20 brains was 287, with an average (± standard deviation) of 14.35 ± 1.24 perforators per brain (range seven to 28). Their origin was as follows: right vertebral artery in 52 perforators (18.11%); left vertebral artery in 35 (12.19%); basilar artery below the anterior inferior cerebellar artery (AICA) in 139 (48.43%); basilar artery above the AICA in 46 (16.02%); AICA in 10 (3.48%); and anterior spinal artery in five (1.74%). Most of the perforators arose as sub-branches of larger trunks; their average outer diameter was 0.16 ± 0.006 mm while that of trunks was 0.35 ± 0.02 mm. These anatomical data are important for those wishing 1) to study the pathophysiology of vascular insults to this area caused by atheromas, thrombi, and emboli; 2) to plan vertebrobasilar aneurysm surgery; 3) to plan surgery for vertebrobasilar insufficiency; and 4) to study foramen magnum neoplasms.

scholarly journals A Modified Surgical Technique for Transposition of the Vertebral Artery to the Common Carotid Artery

2018 ◽  
Vol 10 (3) ◽  
pp. 292-296
Author(s):  
Won-Bae Seung
Keyword(s):  
Carotid Artery ◽  
Vertebral Artery ◽  
Posterior Wall ◽  
Common Finding ◽  
Resonance Imaging ◽  
Current Case ◽  
Number Of Patients ◽  
Limited Length ◽  
The Common ◽  
Collateral Vessels

A proximal occluded vertebral artery (VA) with reconstitution by muscular collateral vessels is a relatively common finding. However, due to inadequate intracranial anastomosis and hypoplasia or stenosis of the opposite VA, a number of patients develop symptoms of brain ischemia. In the current case, a 63-year-old man presented with repeat neurological symptoms such as dizziness, nausea, vomiting, dysarthria, left hemiparesis, and right hemianopsia. Magnetic resonance imaging revealed multiple posterior infarctions. Angiography revealed the VA to be occluded and reconstituted by collateral vessels. Considering the above results, we performed vertebral carotid artery transposition. However, several technical difficulties were encountered due to space limitations in the operative field and the limited length of the vessels to be anastomosed. To overcome such situations, we introduced a modified posterior wall end-to-side anastomosis technique.

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