PDF herunterladen
CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2024; 43(04): e365-e368
DOI: 10.1055/s-0044-1795135
Case Report

Vertebral Artery Stenosis Caused by Cervical Osteophyte: A Rare and Reversible Cause of Vertebrobasilar Insufficiency. Case Report

Estenose da artéria vertebral causada por Osteófito Cervical: Uma causa rara e reversível de insuficiência vertebrobasilar. Relato de caso
Pedro Nogarotto Cembraneli 
1   Department of Neurosurgery, Hospital de Neurologia Santa Mônica, Goiânia, GO, Brazil
,
Julia Brasileiro de Faria Cavalcante
1   Department of Neurosurgery, Hospital de Neurologia Santa Mônica, Goiânia, GO, Brazil
,
Renata Brasileiro de Faria Cavalcante
1   Department of Neurosurgery, Hospital de Neurologia Santa Mônica, Goiânia, GO, Brazil
,
Italo Nogarotto Cembraneli
2   University of Medicine, Centro Universitário de Mineiros, Mineiros, GO, Brazil
,
Leonardo Taveira Lopes
1   Department of Neurosurgery, Hospital de Neurologia Santa Mônica, Goiânia, GO, Brazil
,
José Edison da Silva Cavalcante
1   Department of Neurosurgery, Hospital de Neurologia Santa Mônica, Goiânia, GO, Brazil
,
Alessandro Fonseca Cardoso
1   Department of Neurosurgery, Hospital de Neurologia Santa Mônica, Goiânia, GO, Brazil
,
Chrystiano Fonseca Cardoso
1   Department of Neurosurgery, Hospital de Neurologia Santa Mônica, Goiânia, GO, Brazil
,
Marco Antônio Zanini
3   Department of Neurosurgery, São Paulo State University, Botucatu, SP, Brazil
› Institutsangaben
› Weitere Informationen
Auch verfügbar auf
   Lizenzen und Reprints

Abstract

Bow Hunter syndrome manifests when the vertebral artery is compressed following head rotation. Symptomatic compression with vertebral artery stenosis due to cervical osteophytes is a rare cause and occurs due to a progressive degenerative process. In most cases, compression originates anteromedially from the uncinate process and is asymptomatic due to the competence of the contralateral vertebral artery. In the described patient, compression presented superomedially due to osteophytes in the superior articular facet of the C5 vertebra, and the contralateral vertebral artery was obstructed. Careful evaluation with imaging, mainly preoperative 3D angiotomography, is necessary to determine the most beneficial approach for decompression. The treatment of choice for symptomatic compression induced by cervical spondylosis is decompression surgery.

Resumo

A síndrome de Bow Hunter se manifesta quando a artéria vertebral é comprimida após a rotação da cabeça. A compressão sintomática com estenose da artéria vertebral devido a osteófitos cervicais é uma causa rara e ocorre devido a um processo degenerativo progressivo. Geralmente, a compressão se origina anteromedialmente do processo uncinado e é assintomática devido à competência da artéria vertebral contralateral. No paciente descrito, a compressão se apresentou superomedialmente devido a osteófitos na faceta articular superior da vértebra C5, e a artéria vertebral contralateral estava obstruída. Uma avaliação cuidadosa com imagens, principalmente angiotomografia 3D pré-operatória, é necessária para determinar a abordagem mais benéfica para a descompressão. O tratamento de escolha para compressão sintomática induzida por espondilose cervical é a cirurgia de descompressão.

Keywords

vertebral artery - vertebrobasilar insufficiency - osteophyte - Bow Hunter's Syndrome

Palavras-chave

artéria vertebral - insuficiência vertebrobasilar - osteófito - Síndrome de Bow Hunter


Publikationsverlauf

Eingereicht: 07. April 2024

Angenommen: 18. Oktober 2024

Artikel online veröffentlicht:
11. Dezember 2024

© 2024. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • References

  • 1 Khan S, Cloud GC, Kerry S, Markus HS. Imaging of vertebral artery stenosis: a systematic review. J Neurol Neurosurg Psychiatry 2007; 78 (11) 1218-1225
    CrossrefPubMedSuche in Google Scholar
  • 2 Citow JS, Macdonald RL. Posterior decompression of the vertebral artery narrowed by cervical osteophyte: case report. Surg Neurol 1999; 51 (05) 495-498 , discussion 498–499
    CrossrefPubMedSuche in Google Scholar
  • 3 Cloud GC, Markus HS. Vertebral artery stenosis. Curr Treat Options Cardiovasc Med 2004; 6 (02) 121-127
    CrossrefPubMedSuche in Google Scholar
  • 4 Kadanka Z, Mares M, Bednarík J. et al. Predictive factors for mild forms of spondylotic cervical myelopathy treated conservatively or surgically. Eur J Neurol 2005; 12 (01) 16-24
    CrossrefPubMedSuche in Google Scholar
  • 5 Chagas H, Domingues F, Aversa A, Vidal Fonseca AL, de Souza JM. Cervical spondylotic myelopathy: 10 years of prospective outcome analysis of anterior decompression and fusion. Surg Neurol 2005; 64 (Suppl. 01) S1 , 30–35, discussion S1, 35–36
    PubMedSuche in Google Scholar
  • 6 Theodore N. Espondilose Cervical Degenerativa. N Engl J Med 2020; 383: 159
    CrossrefPubMedSuche in Google Scholar
  • 7 Sadasivan KK, Reddy RP, Albright JA. The natural history of cervical spondylotic myelopathy. Yale J Biol Med 1993; 66 (03) 235-242
    PubMedSuche in Google Scholar
  • 8 Kubik CS, Adams RD. Occlusion of the basilar artery; a clinical and pathological study. Brain 1946; 69 (02) 73-121
    CrossrefPubMedSuche in Google Scholar
  • 9 Special report from the National Institute of Neurological Disorders and Stroke. Classification of cerebrovascular diseases III. Stroke 1990; 21 (04) 637-676
    CrossrefPubMedSuche in Google Scholar
  • 10 Savitz SI, Caplan LR. Vertebrobasilar disease. N Engl J Med 2005; 352 (25) 2618-2626
    CrossrefPubMedSuche in Google Scholar
  • 11 Simoceli L, Bittar RMS, Bottino MA, Bento RF. Perfil diagnóstico do idoso portador de desequilíbrio corporal: resultados preliminares. Rev Bras Otorrinolaringol 2003; 69: 772-777
    CrossrefPubMedSuche in Google Scholar
  • 12 Edlow JA, Newman-Toker DE, Savitz SI. Diagnosis and initial management of cerebellar infarction. Lancet Neurol 2008; 7 (10) 951-964
    CrossrefPubMedSuche in Google Scholar
  • 13 Nagashima C. Surgical treatment of vertebral artery insufficiency caused by cervical spondylosis. J Neurosurg 1970; 32 (05) 512-521
    CrossrefPubMedSuche in Google Scholar
  • 14 Berguer R, Flynn LM, Kline RA, Caplan L. Surgical reconstruction of the extracranial vertebral artery: management and outcome. J Vasc Surg 2000; 31 (1 Pt 1): 9-18
    CrossrefPubMedSuche in Google Scholar
  • 15 George B, Bruneau M, Spetzler R. Pathology and surgery around the vertebral artery. 2011
    PubMedSuche in Google Scholar
  • 16 Madonis SM, Jenkins JS. Vertebral artery stenosis. Prog Cardiovasc Dis 2021; 65 (March): 55-59
    CrossrefPubMedSuche in Google Scholar
  • 17 Olin JW, Gornik HL, Bacharach JM. et al; American Heart Association Council on Peripheral Vascular Disease, American Heart Association Council on Clinical Cardiology, American Heart Association Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation, American Heart Association Council on Cardiovascular Disease in the Young, American Heart Association Council on Cardiovascular Radiology and Intervention, American Heart Association Council on Epidemiology and Prevention, American Heart Association Council on Functional Genomics and Translational Biology, American Heart Association Council for High Blood Pressure Research, American Heart Association Council on the Kidney in Cardiovascular Disease, American Heart Association Stroke Council. Fibromuscular dysplasia: state of the science and critical unanswered questions: a scientific statement from the American Heart Association. Circulation 2014; 129 (09) 1048-1078
    CrossrefPubMedSuche in Google Scholar
  • 18 Olin JW, Froehlich J, Gu X. et al. The United States Registry for Fibromuscular Dysplasia: results in the first 447 patients. Circulation 2012; 125 (25) 3182-3190
    CrossrefPubMedSuche in Google Scholar
  • 19 Duan G, Xu J, Shi J, Cao Y. Advances in the pathogenesis, diagnosis and treatment of bow hunter's syndrome: a comprehensive review of the literature. Intervent Neurol 2016; 5 (1-2): 29-38
    CrossrefPubMedSuche in Google Scholar
  • 20 Burle VS, Panjwani A, Mandalaneni K, Kollu S, Gorantla VR. Vertebral artery stenosis: a narrative review. Cureus 2022; 14 (08) e28068
    PubMedSuche in Google Scholar
  • 21 Zaidi HA, Albuquerque FC, Chowdhry SA, Zabramski JM, Ducruet AF, Spetzler RF. Diagnosis and management of bow hunter's syndrome: 15-year experience at barrow neurological institute. World Neurosurg 2014; 82 (05) 733-738
    CrossrefPubMedSuche in Google Scholar
  • 22 Kieffer E, Praquin B, Chiche L, Koskas F, Bahnini A. Distal vertebral artery reconstruction: long-term outcome. J Vasc Surg 2002; 36 (03) 549-554
    CrossrefPubMedSuche in Google Scholar
  • 23 Sloan MA, Alexandrov AV, Tegeler CH. et al; Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Assessment: transcranial Doppler ultrasonography: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2004; 62 (09) 1468-1481
    CrossrefPubMedSuche in Google Scholar
  • 24 Thomas B, Barreau X, Pointillart V, Sibon I, Renou P. Endovascular embolization of a nondominant vertebral artery compressed by an osteophyte to prevent recurrence of vertebrobasilar infarctions. J Stroke Cerebrovasc Dis 2015; 24 (09) e257-e259
    CrossrefPubMedSuche in Google Scholar
  • 25 Ndongo Sonfack DJ, Bojanowski MW, Tarabay B, Gennari A, Shédid D, Yuh SJ. Vertebral artery stenosis from osteophyte: A systematic review and case series. Neurochirurgie 2024; 70 (03) 101525
    CrossrefPubMedSuche in Google Scholar
  • 26 Denis DJ, Shedid D, Shehadeh M, Weil AG, Lanthier S. Cervical spondylosis: a rare and curable cause of vertebrobasilar insufficiency. Eur Spine J 2014; 23 (Suppl. 02) 206-213
    CrossrefPubMedSuche in Google Scholar
  • 27 Bulsara KR, Velez DA, Villavicencio A. Rotational vertebral artery insufficiency resulting from cervical spondylosis: case report and review of the literature. Surg Neurol 2006; 65 (06) 625-627
    CrossrefPubMedSuche in Google Scholar
  • 28 Méndez GEF, Chacón CJR, Núñez NJB, Zerpa JR. Utility of Intraoperative Ultrasound in Neurosurgery. Braz Neurosurg 2021; 40 (02) e113-e
    PubMedSuche in Google Scholar
  • 29 Miele VJ, France JC, Rosen CL. Subaxial positional vertebral artery occlusion corrected by decompression and fusion. Spine 2008; 33 (11) E366-E370
    CrossrefPubMedSuche in Google Scholar
  • 30 Matsuyama T, Morimoto T, Sakaki T. Comparison of C1-2 posterior fusion and decompression of the vertebral artery in the treatment of bow hunter's stroke. J Neurosurg 1997; 86 (04) 619-623
    CrossrefPubMedSuche in Google Scholar