Abstract
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. In this case, we report the additional value of three-dimensional reconstructed cone-beam CT angiographic imaging that led to the successful diagnosis of bilateral positional vertebrobasilar disease. The patient subsequently received C4-C6 cervical decompression and fusion and remains symptom free at 1 year follow-up.
Original language | English (US) |
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Pages (from-to) | 73-78 |
Number of pages | 6 |
Journal | Interventional Neuroradiology |
Volume | 23 |
Issue number | 1 |
DOIs | |
State | Published - 2017 |
Keywords
- Bow hunter's syndrome
- C-arm cone-beam CT
- DynaCT
- Vertebrobasilar insufficiency
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Clinical Neurology
- Cardiology and Cardiovascular Medicine