Cervical myelopathy has become commonly recognized as a complication of rheumatoid atlantoaxial subluxation. A small group of patients with atlantoaxial subluxation may have intermittent symptoms associated with change of head position and which are due to vertebral artery compression. Two such cases are reported, one with necropsy findings of infarction in the area supplied by the vertebrobasi...

Bow Hunter‘s Syndrome (BHS) is a mechanical compression of the vertebral artery during head rotation, leading to partial disruption or complete interruption blood flow affected artery, causing vertebrobasilar vascular insufficiency. There are no established precise diagnostic and therapeutic behavioral algorithms in patients with BHS. I present case an 80-year-old woman syncopal sympt...

Symptoms compatible with vertebrobasilar ischemia have been reported in patients with unilateral or bilateral carotid occlusive disease. Intracranial steal phenomena have been proposed to explain the symptoms. In a review of 54 patients with angiographically documented severe bilateral carotid stenosis (less than or equal to 2 mm residual lumen) or occlusion, eight had symptoms suggesting verte...

A 77-year-old man presented with 2 episodes of waking up with symptoms of vertebrobasilar ischemia (figure, A and B) within 6 months. A CT angiogram showed narrowing of the right vertebral artery due to extrinsic compression by an osteophyte of the superior articular process of the fourth cervical vertebra, compromising the foramen transversarium (figure, C and D). Dynamic angiography demonstra...

The arteriograms and other findings in 42 patients with the subclavian steal syndrome were statistically evaluated to determine which factors predisposed to vertebrobasilar ischemia. Evidence of disconnection of the circle of Willis between the territories of the carotid and vertebral arteries was found in a significantly higher proportion of the patients with vertebrobasilar insufficiency. Thi...

Cervical manipulation occasionally causes serious vertebrobasilar complications. The usual cause is vertebral artery dissection, however in some cases there has been no obvious arterial injury. The present paper reviews the mechanisms by which complications occur, particularly when the applied force is trivial or there is no injury to the vertebral arteries, and the factors that increase risk o...

Pathogenesis and Natural History of Transient Global Amnesia • Fourteen patients aged between 49 and 92 years who had suffered from one or more attacks of transient global amnesia (TGA) have been followed for a mean interval of 30 months. Thirteen patients had one or more risk factors for cerebrovascular disease, such as hypertension, cardiac abnormalities, diabetes and hyperlipidemia. Clinical...