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Classification of vertebral artery loop formation and association with cervicogenic dizziness

Published online by Cambridge University Press:  27 October 2016

A Yenigun ,
M E Ustun ,
S Tugrul ,
R Dogan  and
O Ozturan
A Yenigun*
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Bezmialem Vakif University, Fatih, Istanbul, Turkey
M E Ustun
Affiliation:
Neurosurgery Clinic, Konya Hospital, Turkey
S Tugrul
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Bezmialem Vakif University, Fatih, Istanbul, Turkey
R Dogan
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Bezmialem Vakif University, Fatih, Istanbul, Turkey
O Ozturan
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Bezmialem Vakif University, Fatih, Istanbul, Turkey
*
Address for correspondence: Dr Alper Yenigun, Department of Otorhinolaryngology, Faculty of Medicine, Bezmialem Vakif University, Vatan Street, Adnan Menderes Blvd, 34093 Fatih/Istanbul Fax: +90 (212) 453 18 70 E-mail: alperyenigun@gmail.com
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Abstract

Objective:

An examination was conducted of the number, level, clinical association and treatment approaches for vertebral arterial loop formation in patients with this condition with and without concurrent cervicogenic dizziness, and classified them according to the vertebral artery segment in which it was present.

Method:

A cross-sectional retrospective study.

Results:

Thirty-seven patients who had undergone double-sided magnetic resonance angiography were examined; vertebral arterial loop formation was observed at only 1 level in 26 patients and at several levels in 9 patients. Segment one (V1) was involved in 78.3 per cent of cases and segment two (V2) was involved in 21.6 per cent. Symptoms in patients with vertebral arterial loop formation included: positional vertigo, in 100 per cent; and pulsatile tinnitus, in 83.7 per cent.

Conclusion:

Loop formation at the vertebral artery was observed most often on the proximal side in patients with cervicogenic dizziness (78.3 per cent). The incidence on the left side was twice as high as on the right side.

Keywords

Vertebral ArteryMagnetic Resonance AngiographyVertigoDizziness
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 12 , December 2016 , pp. 1115 - 1119
Copyright
Copyright © JLO (1984) Limited 2016 

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References

1 Reid, SA, Rivett, DA. Manual therapy treatment of cervicogenic dizziness: a systematic review. Man Ther 2005;10:4–13 Google Scholar
2 Han, BI, Song, HS, Kim, JS. Vestibular rehabilitation therapy: review of indications, mechanisms, and key exercises. J Clin Neurol 2011;7:184–96CrossRefGoogle ScholarPubMed
3 Lystad, RP, Bell, G, Bonnevie-Svendsen, M, Carter, CV. Manual therapy with and without vestibular rehabilitation for cervicogenic dizziness: a systematic review. Chiropr Man Therap 2011;18:19–21 Google Scholar
4 Furman, JM, Whitney, SL. Central causes of dizziness. Phys Ther 2000;80:179–87CrossRefGoogle ScholarPubMed
5 Olszewski, J, Repetowski, M. Clinical analysis in patients with cervical vertigo in ENT [in Polish]. Otolaryngol Pol 2008;62:283–7Google Scholar
6 Bracher, ES, Almeida, CI, Almeida, RR, Duprat, AC, Bracher, CB. A combined approach for the treatment of cervical vertigo. J Manipulative Physiol Ther 2000;23:96–100 Google Scholar
7 Wrisley, DM, Sparto, PJ, Whitney, SL. Cervicogenic dizziness: a review of diagnosis and treatment. J Orthop Sports Phys Ther 2000;30:755–66CrossRefGoogle ScholarPubMed
8 Kim, HS, Lee, JH, Cheh, G, Lee, SH. Cervical radiculopathy caused by vertebral artery loop formation: a case report and review of the literature. J Korean Neurosurg Soc 2010;48:465–8CrossRefGoogle ScholarPubMed
9 Epstein, NE, Silvergleid, R. Magnetic resonance angiographic diagnosis of ectatic vertebral artery. J Spinal Disord 1995;8:308–10CrossRefGoogle ScholarPubMed
10 George, B. Extracranial vertebral artery anatomy and surgery. Adv Tech Stand Neurosurg 2002;27:179–216 Google Scholar
11 Zhang, DP, Zhang, SL, Zhang, HT, Zhang, SJ. Vertebral artery dominance, brainstem auditory evoked potential, and vertigo of vascular origin. Neurol Res 2012;34:498–503 Google Scholar
12 Cosar, M, Yaman, M, Eser, O, Songur, A, Ozen, OA. Basilar artery angulation and vertigo due to the hemodynamic effect of dominant vertebral artery. Med Hypotheses 2008;70:941–3Google Scholar
13 Ranganatha Sastry, V, Manjunath, KY. The course of the V1 segment of the vertebral artery. Ann Indian Acad Neurol 2006;9:223–6Google Scholar
14 Hadley, LA. Tortuosity and deflection of the vertebral artery. Am J Roentgenol Radium Ther Nucl Med 1958;80:306–12Google Scholar
15 Paksoy, Y, Levendoglu, FD, Ogün, CO, Ustün, ME, Ogün, TC. Vertebral artery loop formation: a frequent cause of cervicobrachial pain. Spine (Phila Pa 1976) 2003;28:1183–8Google Scholar
16 Oga, M, Yuge, I, Terada, K, Shimizu, A, Sugioka, Y. Tortuosity of the vertebral artery in patients with cervical spondylotic myelopathy. Risk factor for the vertebral artery injury during anterior cervical decompression. Spine (Phila Pa 1976) 1996;21:1085–9CrossRefGoogle ScholarPubMed
17 Sakaida, H, Okada, M, Yamamoto, A. Vascular reconstruction of a vertebral artery loop causing cervical radiculopathy and vertebrobasilar insufficiency. Case report. J Neurosurg 2001;94:145–9Google Scholar
18 Bruneau, M, Cornelius, JF, Marneffe, V, Triffaux, M, George, B. Anatomical variations of the V2 segment of the vertebral artery. Neurosurgery 2006;59:20–4Google Scholar
19 Lee, CS, Lee, HY, Yang, TK. Rotational vertebral artery occlusion syndrome: misnomers and classification. Clin Neurol Neurosurg 2015;131:18–20 Google Scholar
20 Kuether, TA, Nesbit, GM, Clark, WM, Barnwell, SL. Rotational vertebral artery occlusion: a mechanism of vertebrobasilar insufficiency. Neurosurgery 1997;41:427–32Google Scholar
21 Psillas, G, Kekes, G, Constantinidis, J, Triaridis, S, Vital, V. Subclavian steal syndrome: neurotological manifestations. Acta Otorhinolaryngol Ital 2007;27:33–7Google ScholarPubMed