Korean J Otorhinolaryngol-Head Neck Surg.  2016 Nov;59(11):796-801. 10.3342/kjorl-hns.2016.59.11.796.

A Case of Rotational Vertebral Artery Syndrome Diagnosed with Color Doppler-Assisted Carotid Duplex Sonography Imaging

• Kim SH

• KMID: 2359370
• DOI: http://doi.org/10.3342/kjorl-hns.2016.59.11.796

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.

Keyword

Carotid duplex ultrasound; Rotational vertebral artery syndrome

MeSH Terms

Angiography
Head
Humans
Ischemic Attack, Transient
Methods
Neck
Nystagmus, Pathologic
Syncope
Ultrasonography
Vertebral Artery*
Vertigo
Vestibule, Labyrinth