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Vertebral artery syndrome

MedGen UID:
419936
•Concept ID:
C2931914
•
Disease or Syndrome
Synonym: PICA syndrome
SNOMED CT: Vertebral artery syndrome (34781003)

Definition

A syndrome which occurs as a result of the occlusion of one of the vertebral arteries. It may be caused by atherosclerosis, embolism or hemorrhage. Collateral circulation through the circle of Willis is usually comprised as well. Clinical signs may include vertigo, nystagmus, dysarthria, ataxia and sensorimotor deficits. Clinical course may lead to persistence of neurologic deficits. Prognosis is variable with a substantial risk for recurrent infarction. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVVertebral artery syndrome

Professional guidelines

PubMed

Vascular vertigo and dizziness: Diagnostic criteria.
Kim JS, Newman-Toker DE, Kerber KA, Jahn K, Bertholon P, Waterston J, Lee H, Bisdorff A, Strupp M
J Vestib Res 2022;32(3):205-222. doi: 10.3233/VES-210169. PMID: 35367974Free PMC Article

Recent clinical studies

Etiology

Association of Vertebral Artery Hypoplasia and Vertebrobasilar Cerebrovascular Accident.
Vilimas A, Gaigalaitė V, Urbonas M, Jatužis D
Medicina (Kaunas) 2022 Aug 31;58(9) doi: 10.3390/medicina58091189. PMID: 36143866Free PMC Article
Bow hunter syndrome: A rare yet important etiology of posterior circulation stroke.
Qashqari H, Bhathal I, Pulcine E, Muthusami P, Moharir M, MacGregor D, Kulkarni A, Dlamini N
J Clin Neurosci 2020 Aug;78:418-419. Epub 2020 Jun 7 doi: 10.1016/j.jocn.2020.04.110. PMID: 32522486
Subaxial rotational vertebral artery syndrome: resection of the uncinate process and anterior fusion can be sufficient!: case report and review of the literature.
Schelfaut S, Verhasselt S, Carpentier K, Moke L
J Spinal Disord Tech 2015 Mar;28(2):66-70. doi: 10.1097/BSD.0b013e3182886fbf. PMID: 23429312
Bow hunter's syndrome causing vertebrobasilar insufficiency in a young man with neck muscle hypertrophy.
Sarkar J, Wolfe SQ, Ching BH, Kellicut DC
Ann Vasc Surg 2014 May;28(4):1032.e1-1032.e10. Epub 2013 Nov 1 doi: 10.1016/j.avsg.2013.06.038. PMID: 24184499
Rotational vertebral artery occlusion-series of 9 cases.
Lu DC, Zador Z, Mummaneni PV, Lawton MT
Neurosurgery 2010 Oct;67(4):1066-72; discussion 1072. doi: 10.1227/NEU.0b013e3181ee36db. PMID: 20881570

Diagnosis

Cervicogenic causes of vertigo.
Hain TC
Curr Opin Neurol 2015 Feb;28(1):69-73. doi: 10.1097/WCO.0000000000000161. PMID: 25502050
Subaxial rotational vertebral artery syndrome: resection of the uncinate process and anterior fusion can be sufficient!: case report and review of the literature.
Schelfaut S, Verhasselt S, Carpentier K, Moke L
J Spinal Disord Tech 2015 Mar;28(2):66-70. doi: 10.1097/BSD.0b013e3182886fbf. PMID: 23429312
Bow hunter's syndrome causing vertebrobasilar insufficiency in a young man with neck muscle hypertrophy.
Sarkar J, Wolfe SQ, Ching BH, Kellicut DC
Ann Vasc Surg 2014 May;28(4):1032.e1-1032.e10. Epub 2013 Nov 1 doi: 10.1016/j.avsg.2013.06.038. PMID: 24184499
Rotational vertebral artery syndrome: 3D kinematics of nystagmus suggest bilateral labyrinthine dysfunction.
Marti S, Hegemann S, von Büdingen HC, Baumgartner RW, Straumann D
J Neurol 2008 May;255(5):663-7. Epub 2008 Feb 18 doi: 10.1007/s00415-008-0773-2. PMID: 18274804
Rotational vertebral artery syndrome: oculographic analysis of nystagmus.
Choi KD, Shin HY, Kim JS, Kim SH, Kwon OK, Koo JW, Park SH, Yoon BW, Roh JK
Neurology 2005 Oct 25;65(8):1287-90. doi: 10.1212/01.wnl.0000180405.00560.51. PMID: 16247059

Therapy

Challenges of anaesthetising a child with Bow Hunter's syndrome and dilated cardiomyopathy for occipitocervical fusion.
Renthlei L, Mariappan R, Raju K, Joseph J
BMJ Case Rep 2023 May 2;16(5) doi: 10.1136/bcr-2022-253834. PMID: 37130633Free PMC Article
Association of Vertebral Artery Hypoplasia and Vertebrobasilar Cerebrovascular Accident.
Vilimas A, Gaigalaitė V, Urbonas M, Jatužis D
Medicina (Kaunas) 2022 Aug 31;58(9) doi: 10.3390/medicina58091189. PMID: 36143866Free PMC Article
Rotational vertebral artery syndrome in moyamoya disease: a sign of unilateral vertebral artery stenosis.
Choi KH, Lee SH, Kim JM, Oh DS, Kim JT, Park MS, Cho KH
Clin Neurol Neurosurg 2013 Sep;115(9):1900-2. Epub 2013 Jun 4 doi: 10.1016/j.clineuro.2013.05.004. PMID: 23759342
Rotational vertebral artery syndrome: 3D kinematics of nystagmus suggest bilateral labyrinthine dysfunction.
Marti S, Hegemann S, von Büdingen HC, Baumgartner RW, Straumann D
J Neurol 2008 May;255(5):663-7. Epub 2008 Feb 18 doi: 10.1007/s00415-008-0773-2. PMID: 18274804
Rotational vertebral artery syndrome: oculographic analysis of nystagmus.
Choi KD, Shin HY, Kim JS, Kim SH, Kwon OK, Koo JW, Park SH, Yoon BW, Roh JK
Neurology 2005 Oct 25;65(8):1287-90. doi: 10.1212/01.wnl.0000180405.00560.51. PMID: 16247059

Prognosis

Bow hunter's syndrome causing vertebrobasilar insufficiency in a young man with neck muscle hypertrophy.
Sarkar J, Wolfe SQ, Ching BH, Kellicut DC
Ann Vasc Surg 2014 May;28(4):1032.e1-1032.e10. Epub 2013 Nov 1 doi: 10.1016/j.avsg.2013.06.038. PMID: 24184499

Clinical prediction guides

Bow hunter's syndrome causing vertebrobasilar insufficiency in a young man with neck muscle hypertrophy.
Sarkar J, Wolfe SQ, Ching BH, Kellicut DC
Ann Vasc Surg 2014 May;28(4):1032.e1-1032.e10. Epub 2013 Nov 1 doi: 10.1016/j.avsg.2013.06.038. PMID: 24184499
Origin of isolated vertigo in rotational vertebral artery syndrome.
Kim HA, Yi HA, Lee CY, Lee H
Neurol Sci 2011 Dec;32(6):1203-7. Epub 2011 Jun 28 doi: 10.1007/s10072-011-0667-4. PMID: 21710126
Rotational vertebral artery syndrome due to compression of nondominant vertebral artery terminating in posterior inferior cerebellar artery.
Noh Y, Kwon OK, Kim HJ, Kim JS
J Neurol 2011 Oct;258(10):1775-80. Epub 2011 Mar 17 doi: 10.1007/s00415-011-6005-1. PMID: 21416208
Rotational vertebral artery occlusion-series of 9 cases.
Lu DC, Zador Z, Mummaneni PV, Lawton MT
Neurosurgery 2010 Oct;67(4):1066-72; discussion 1072. doi: 10.1227/NEU.0b013e3181ee36db. PMID: 20881570

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