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Anatomic Considerations and Relationship between Vertebral Artery and Transverse Foramina at Cervical Vertebrae 1 to 6 in Vertigo Patients

Year 2018, Volume: 8 Issue: 3, 185 - 194, 18.12.2018
https://doi.org/10.32448/entupdates.507983

Abstract











Objectives:
In the present study, we investigated the relationship between
vertebral artery and transverse foramina of the C1 to C6 vertebrae in
patients with vertigo suspected as vertebrobasilar insufficiency
(VBI).







Patients
and Methods:
In
this retrospective study, Cervical Computed Tomography (CT) of 22
adult patients with vertigo and
control
group comprising 23 healthy adulti ndivıduals
were
included. Vertebral artery and transverse foramina measurements
(Sagittal and transverse dimensions; and area) were performed at the
levels of cervical 1 (C1) to cervical 6 (C6) vertebrae bilaterally.







Results:
At
C6 level, right vertebral artery area; and sagittal and transverse
diameter; and

atthe C1 level, right transverse foramina area of the vertigo group
were significantly higher than the control group.
Vertebral
artery area values were positively correlated with ipsilateral
transverse foramina values (
transverse
foramen sagittal and transverse dimensions; and areas) at C1 to C5
levels. When transverse foramina sagittal or transvers
e
dimensions; or transverse foramina areas decreased, vertebral artery
areas also decreased at C1 to C5 levels.







Conclusion:
We
concluded that a decrease in the diameters of bony structure or
transverse foramina may cause a decrease
in
the

area of the vertebral artery at the ipsilateral side.As the left
vertebral artery is dominant for cerebral blood flow, an increase of
the right vertebral artery area cannot affect cerebral blood flow.
Decreased blood flow on the left side may play a role in the
development of vertigo, in other words,VBI.

References

  • 1.No authors listed. Special report from the National Institute of Neurological Disorders and Stroke. Classification of cerebrovascular diseases III. Stroke1990; 21:637–76.
  • 2. Grad A, Baloh RW. Vertigo of vascular origin: Clinical and electro-nystagmographic features in 84 cases. Arch Neurol 1989; 46:281–4.
  • 3. Savitz SI, Caplan LR. Vertebrobasilar disease. N Engl J Med 2005; 352:2618–26.
  • 4. Doss A, Phatouros CC. Vertebrobasilar insufficiency. Curr Treat Options Cardiovasc Med.2006; 8:111-9.
  • 5. Lima Neto AC, Bittar R, Gattas GS, et al. Pathophysiology and Diagnosis of Vertebrobasilar Insufficiency: A Review of the Literature. Int Arch Otorhinolaryngol. 2017; 21:302-7. doi: 10.1055/s-0036-1593448. Epub 2016 Oct 26.
  • 6. Thiel H, Wallace K, Donat J, Yong-Hing K. Effect of various head neck positions on vertebral artery blood flow. Clin Biomech. 1994;9:105-10.
  • 7. Troost BT. Dizziness and vertigo in vertebrobasilar disease. Part 1: peripheral and systemic causes dizziness. Stroke 1980;11:301-3.
  • 8. Bergan JJ, Levy JS, Trippel OH, Jurayj M. Vascular implications of vertigo. Arch Otolaryngol 1967;85:292- 7.
  • 9. Fisher CM. Vertigo in cerebrovascular disease. Arch Otolaryngol 1967;85:529-34.
  • 10. Haldeman S, Kohlbeck FJ, McGregor M. Unpredictability of cerebrovascular ischemia associated with cervical spine manipulation therapy: a review of sixtyfour cases after cervical spine manipulation. Spine 2002;27:49-55.
  • 11. Gomez CR, Cruz-Flores S, Malkoff MD, Sauer CM, Burch CM . Isolated vertigo as a manifestation of vertebrobasilar ischemia. Neurology. 1996;47:94-7.
  • 12. Grad A, Baloh RW.Vertigo of vascular origin. Clinical and electronystagmographic features in 84 cases. Arch Neurol. 1989;46:281-4.
  • 13. Asavasopon S, Jankoski J, Godges JJ. Clinical diagnosis of vertebrobasilar insufficiency: resident's case problem. J Orthop Sports PhysTher. 2005;35:645-50.
  • 14. Troost BT. Dizziness and vertigo in vertebrobasilar disease. Part II. Central causes and vertebrobasilar disease. Stroke 1980;11:413-5.
  • 15. Rother J, Wentz KU, Rautenberg W, Schwartz A, Hennerici M. Magnetic resonance angiography in vertebrobasilarischemia. Stroke 1993; 24:1310-5.
  • 16. Fox MW, Piepgras DG, Bartleson JD. Anterolateral decompression of the atlantoaxial vertebral artery for symptomaticpositional occlusion of the vertebral artery. Case report. J Neurosurg. 1995;83:737-40.
  • 17. Vates GE, Wang KC, Bonovich D, Dowd CF, Lawton MT. Bow hunter stroke caused by cervical disc herniation. Case report. J Neurosurg. 2002;96(1 Suppl):90-3.
  • 18.Albuquerque FC, Hu YC, Dashti SR, et al. Craniocervical arterial dissections as sequelae of chiropractic manipulation: patternsof injury and management. J Neurosurg. 2011;115:1197-205.
  • 19. Alnaami I, Siddiqui M, Saqqur M. The diagnosis of vertebrobasilar insufficiency using transcranial Doppler ultrasound. Case Rep Med. 2012:894913. doi: 10.1155/2012/894913. Epub 2012 Nov 8.
  • 20. Otto V, Fischer B, Schwarz M, Baumann W, Preibisch-Effenberger R. Treatment of vertebrobasilar insufficiency--associated vertigo with a fixedcombination of cinnarizine and dimenhydrinate. Int Tinnitus J. 2008;14:57-67.
  • 21.Ha W, Yang D, Gu S, et al.Anatomical study of suboccipital vertebral arteries and surrounding bony structures using virtualreality technology. Med SciMonit. 2014;20:802-6. doi: 10.12659/MSM.890840.
  • 22. Cote P, Kreitz BG, Cassidy JD, Thiel H. The validity of the extension-rotation test as a clinical screening procedure before neck manipulation: a secondary analysis. J Manipulative PhysiolTher. 1996;19:159-64.
  • 23. Westaway MD, Stratford P, Symons B. False-negative extension/rotation pre-manipulative screening test on a patient with an atretic and hypoplastic vertebral artery. Man Ther. 2003;8:120-7.
  • 24. Rivett DA, Milburn PD, Chapple C. Negative premanipulative vertebral artery testing despite complete occlusion: a case of false negativity. Man Ther. 1998;2:102-7.
  • 25. Jost GF, Dailey AT. Bow Hunter’s syndrome revisited: 2 new cases and literature review of 124 cases. Neurosurg Focus 2015;38:E7
  • 26. Gordhan A, Lockhart C. Congenital Bilateral C2 Transverse Foramina Stenosis Causing Adult-Onset Vertebrobasilar Insufficiency and Posterior Circulation Stroke. Case Rep Neurol. 2017;9:137-42.
  • 27.  Tsutsumi S, Ito M, Yasumoto Y. Simultaneous bilateral vertebral artery occlusion of the lower cervical spine manifesting as Bow Hunter’s syndrome. Neurol Med Chir (Tokyo) 2008; 48:90–4.
  • 28. Shinohara N, Kohno K, Takeda S, Ohta S, Sakaki S. A case of Bow Hunter’s stroke caused by bilateral vertebral artery occlusive change on head rotation to the right. No ShinkeiGeka 1998; 26:417–22.
  • 29. Fleming JB, Vora TK, Harrigan MR. Rare case of bilateral vertebral artery stenosis caused by C4–5 spondylotic changes manifesting with bilateral Bow Hunter’s syndrome. World Neurosurg 2013;79:799.E1–E5.
  • 30 Akar ZC, Dujovny M, Slavin KV, Gomez-Tortosa E, Ausman JI. Microsurgical anatomy of the intracranial part of the vertebral artery. Neurol Res. 1994;16:171-80.
Year 2018, Volume: 8 Issue: 3, 185 - 194, 18.12.2018
https://doi.org/10.32448/entupdates.507983

Abstract

References

  • 1.No authors listed. Special report from the National Institute of Neurological Disorders and Stroke. Classification of cerebrovascular diseases III. Stroke1990; 21:637–76.
  • 2. Grad A, Baloh RW. Vertigo of vascular origin: Clinical and electro-nystagmographic features in 84 cases. Arch Neurol 1989; 46:281–4.
  • 3. Savitz SI, Caplan LR. Vertebrobasilar disease. N Engl J Med 2005; 352:2618–26.
  • 4. Doss A, Phatouros CC. Vertebrobasilar insufficiency. Curr Treat Options Cardiovasc Med.2006; 8:111-9.
  • 5. Lima Neto AC, Bittar R, Gattas GS, et al. Pathophysiology and Diagnosis of Vertebrobasilar Insufficiency: A Review of the Literature. Int Arch Otorhinolaryngol. 2017; 21:302-7. doi: 10.1055/s-0036-1593448. Epub 2016 Oct 26.
  • 6. Thiel H, Wallace K, Donat J, Yong-Hing K. Effect of various head neck positions on vertebral artery blood flow. Clin Biomech. 1994;9:105-10.
  • 7. Troost BT. Dizziness and vertigo in vertebrobasilar disease. Part 1: peripheral and systemic causes dizziness. Stroke 1980;11:301-3.
  • 8. Bergan JJ, Levy JS, Trippel OH, Jurayj M. Vascular implications of vertigo. Arch Otolaryngol 1967;85:292- 7.
  • 9. Fisher CM. Vertigo in cerebrovascular disease. Arch Otolaryngol 1967;85:529-34.
  • 10. Haldeman S, Kohlbeck FJ, McGregor M. Unpredictability of cerebrovascular ischemia associated with cervical spine manipulation therapy: a review of sixtyfour cases after cervical spine manipulation. Spine 2002;27:49-55.
  • 11. Gomez CR, Cruz-Flores S, Malkoff MD, Sauer CM, Burch CM . Isolated vertigo as a manifestation of vertebrobasilar ischemia. Neurology. 1996;47:94-7.
  • 12. Grad A, Baloh RW.Vertigo of vascular origin. Clinical and electronystagmographic features in 84 cases. Arch Neurol. 1989;46:281-4.
  • 13. Asavasopon S, Jankoski J, Godges JJ. Clinical diagnosis of vertebrobasilar insufficiency: resident's case problem. J Orthop Sports PhysTher. 2005;35:645-50.
  • 14. Troost BT. Dizziness and vertigo in vertebrobasilar disease. Part II. Central causes and vertebrobasilar disease. Stroke 1980;11:413-5.
  • 15. Rother J, Wentz KU, Rautenberg W, Schwartz A, Hennerici M. Magnetic resonance angiography in vertebrobasilarischemia. Stroke 1993; 24:1310-5.
  • 16. Fox MW, Piepgras DG, Bartleson JD. Anterolateral decompression of the atlantoaxial vertebral artery for symptomaticpositional occlusion of the vertebral artery. Case report. J Neurosurg. 1995;83:737-40.
  • 17. Vates GE, Wang KC, Bonovich D, Dowd CF, Lawton MT. Bow hunter stroke caused by cervical disc herniation. Case report. J Neurosurg. 2002;96(1 Suppl):90-3.
  • 18.Albuquerque FC, Hu YC, Dashti SR, et al. Craniocervical arterial dissections as sequelae of chiropractic manipulation: patternsof injury and management. J Neurosurg. 2011;115:1197-205.
  • 19. Alnaami I, Siddiqui M, Saqqur M. The diagnosis of vertebrobasilar insufficiency using transcranial Doppler ultrasound. Case Rep Med. 2012:894913. doi: 10.1155/2012/894913. Epub 2012 Nov 8.
  • 20. Otto V, Fischer B, Schwarz M, Baumann W, Preibisch-Effenberger R. Treatment of vertebrobasilar insufficiency--associated vertigo with a fixedcombination of cinnarizine and dimenhydrinate. Int Tinnitus J. 2008;14:57-67.
  • 21.Ha W, Yang D, Gu S, et al.Anatomical study of suboccipital vertebral arteries and surrounding bony structures using virtualreality technology. Med SciMonit. 2014;20:802-6. doi: 10.12659/MSM.890840.
  • 22. Cote P, Kreitz BG, Cassidy JD, Thiel H. The validity of the extension-rotation test as a clinical screening procedure before neck manipulation: a secondary analysis. J Manipulative PhysiolTher. 1996;19:159-64.
  • 23. Westaway MD, Stratford P, Symons B. False-negative extension/rotation pre-manipulative screening test on a patient with an atretic and hypoplastic vertebral artery. Man Ther. 2003;8:120-7.
  • 24. Rivett DA, Milburn PD, Chapple C. Negative premanipulative vertebral artery testing despite complete occlusion: a case of false negativity. Man Ther. 1998;2:102-7.
  • 25. Jost GF, Dailey AT. Bow Hunter’s syndrome revisited: 2 new cases and literature review of 124 cases. Neurosurg Focus 2015;38:E7
  • 26. Gordhan A, Lockhart C. Congenital Bilateral C2 Transverse Foramina Stenosis Causing Adult-Onset Vertebrobasilar Insufficiency and Posterior Circulation Stroke. Case Rep Neurol. 2017;9:137-42.
  • 27.  Tsutsumi S, Ito M, Yasumoto Y. Simultaneous bilateral vertebral artery occlusion of the lower cervical spine manifesting as Bow Hunter’s syndrome. Neurol Med Chir (Tokyo) 2008; 48:90–4.
  • 28. Shinohara N, Kohno K, Takeda S, Ohta S, Sakaki S. A case of Bow Hunter’s stroke caused by bilateral vertebral artery occlusive change on head rotation to the right. No ShinkeiGeka 1998; 26:417–22.
  • 29. Fleming JB, Vora TK, Harrigan MR. Rare case of bilateral vertebral artery stenosis caused by C4–5 spondylotic changes manifesting with bilateral Bow Hunter’s syndrome. World Neurosurg 2013;79:799.E1–E5.
  • 30 Akar ZC, Dujovny M, Slavin KV, Gomez-Tortosa E, Ausman JI. Microsurgical anatomy of the intracranial part of the vertebral artery. Neurol Res. 1994;16:171-80.
There are 30 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Articles
Authors

Turgut Kültür

Nuray Bayar Muluk This is me

Cihan Iyem

Mikail Inal

Veysel Burulday

Murat Alpua This is me

Umut Orkun Çelebi This is me

Publication Date December 18, 2018
Submission Date September 13, 2018
Published in Issue Year 2018 Volume: 8 Issue: 3

Cite

APA Kültür, T., Bayar Muluk, N., Iyem, C., Inal, M., et al. (2018). Anatomic Considerations and Relationship between Vertebral Artery and Transverse Foramina at Cervical Vertebrae 1 to 6 in Vertigo Patients. ENT Updates, 8(3), 185-194. https://doi.org/10.32448/entupdates.507983
AMA Kültür T, Bayar Muluk N, Iyem C, Inal M, Burulday V, Alpua M, Çelebi UO. Anatomic Considerations and Relationship between Vertebral Artery and Transverse Foramina at Cervical Vertebrae 1 to 6 in Vertigo Patients. ENT Updates. December 2018;8(3):185-194. doi:10.32448/entupdates.507983
Chicago Kültür, Turgut, Nuray Bayar Muluk, Cihan Iyem, Mikail Inal, Veysel Burulday, Murat Alpua, and Umut Orkun Çelebi. “Anatomic Considerations and Relationship Between Vertebral Artery and Transverse Foramina at Cervical Vertebrae 1 to 6 in Vertigo Patients”. ENT Updates 8, no. 3 (December 2018): 185-94. https://doi.org/10.32448/entupdates.507983.
EndNote Kültür T, Bayar Muluk N, Iyem C, Inal M, Burulday V, Alpua M, Çelebi UO (December 1, 2018) Anatomic Considerations and Relationship between Vertebral Artery and Transverse Foramina at Cervical Vertebrae 1 to 6 in Vertigo Patients. ENT Updates 8 3 185–194.
IEEE T. Kültür, “Anatomic Considerations and Relationship between Vertebral Artery and Transverse Foramina at Cervical Vertebrae 1 to 6 in Vertigo Patients”, ENT Updates, vol. 8, no. 3, pp. 185–194, 2018, doi: 10.32448/entupdates.507983.
ISNAD Kültür, Turgut et al. “Anatomic Considerations and Relationship Between Vertebral Artery and Transverse Foramina at Cervical Vertebrae 1 to 6 in Vertigo Patients”. ENT Updates 8/3 (December 2018), 185-194. https://doi.org/10.32448/entupdates.507983.
JAMA Kültür T, Bayar Muluk N, Iyem C, Inal M, Burulday V, Alpua M, Çelebi UO. Anatomic Considerations and Relationship between Vertebral Artery and Transverse Foramina at Cervical Vertebrae 1 to 6 in Vertigo Patients. ENT Updates. 2018;8:185–194.
MLA Kültür, Turgut et al. “Anatomic Considerations and Relationship Between Vertebral Artery and Transverse Foramina at Cervical Vertebrae 1 to 6 in Vertigo Patients”. ENT Updates, vol. 8, no. 3, 2018, pp. 185-94, doi:10.32448/entupdates.507983.
Vancouver Kültür T, Bayar Muluk N, Iyem C, Inal M, Burulday V, Alpua M, Çelebi UO. Anatomic Considerations and Relationship between Vertebral Artery and Transverse Foramina at Cervical Vertebrae 1 to 6 in Vertigo Patients. ENT Updates. 2018;8(3):185-94.