컬러 도플러 경동맥이중초음파검사를 이용하여 진단한 회전성 추골동맥증후군 1예
A Case of Rotational Vertebral Artery Syndrome Diagnosed with Color Doppler-Assisted Carotid Duplex Sonography Imaging
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Rotational vertebral artery syndrome (RVAS) is characterized by recurrent attacks of paroxysmal vertigo, nystagmus, and syncope elicited by head-rotation induced compression of the dominant vertebral artery (VA). Although the cause of RVAS could be explained by transient ischemic attacks within the vertebrobasilar territory, the exact underlying mechanism of the certain specific unilateral lesion of superior vestibular labyrinth responsible for the unidirectional nystagmus is still unclear. This study reports on a patient with right VA hypoplasia, in whom rightward head rotation led to stereotypic clinical symptoms of RVAS including recurrent attacks of vertigo and prominent right beating nystagmus. This patient could be diagnosed with color Doppler-assisted carotid duplex sonography imaging without using of dynamic neck angiography. Carotid duplex ultrasound is rapidly applicable, readily available, safe, real-time monitoring, noninvasive imaging procedure. Color Doppler-assisted carotid duplex sonography imaging therefore should be considered as the first-line diagnostic method in the detection of RVAS. Korean J Otorhinolaryngol-Head Neck Surg 2016;59(11):796-801
Abstract
Rotational vertebral artery syndrome (RVAS) is characterized by recurrent attacks of paroxysmal vertigo, nystagmus, and syncope elicited by head-rotation induced compression of the dominant vertebral artery (VA). Although the cause of RVAS could be explained by transient ischemic attacks within the vertebrobasilar territory, the exact underlying mechanism of the certain specific unilateral lesion of superior vestibular labyrinth responsible for the unidirectional nystagmus is still unclear. This study reports on a patient with right VA hypoplasia, in whom rightward head rotation led to stereotypic clinical symptoms of RVAS including recurrent attacks of vertigo and prominent right beating nystagmus. This patient could be diagnosed with color Doppler-assisted carotid duplex sonography imaging without using of dynamic neck angiography. Carotid duplex ultrasound is rapidly applicable, readily available, safe, real-time monitoring, noninvasive imaging procedure. Color Doppler-assisted carotid duplex sonography imaging therefore should be considered as the first-line diagnostic method in the detection of RVAS. Korean J Otorhinolaryngol-Head Neck Surg 2016;59(11):796-801
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