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Abstract - Original Article

J Cerebrovasc Endovasc Neurosurg. 2019 21(3): 158-162
The Journal of Cerebrovascular and Endovascular Neurosurgery
Rotational vertebral artery syndrome treated via an anterior approach and selective decompression only
Jung Hoon Kang, Soo Bin Im, Je Hoon Jeong, Dong-Seong Shin
Depertment of Neurosurgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. We present the case of a 38-year-old male who complained of repeated dizziness and syncope. Rotational vertebral artery syndrome (RVAS) was diagnosed via videonystagmoraphy (VNG), computed tomography angiography (CTA) and three-position digital subtraction angiography (DSA). In the neutral position, CTA and DSA revealed left vertebral artery (VA) stenosis at the C2 transverse foramen and right VA hypoplasia. When the head was turned to the right, the blood flow stopped at the C2 level. The bony structure around the VA at the C2 transverse foramen was decompressed via an anterior surgical approach, and the symptoms resolved. This case present the precise stenotic point evaluation by three-position DSA is crucial for the planning of surgical treatment.
Key words : Anterior decompression, Nystagmus, Posterior circulation infarction, Rotational vertebral artery syndrome, Videonystagmography

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