第 2 頚神経の絞扼による bow hunter's stroke を呈した症例の外科治療

概要

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A patient is presented with bow hunter's stroke caused by C2 nerve traction of the left vertebral artery on head rotation to the right. The patient was 45-year-old male who had complained of severe vertigo on rotation of the head to the right side for two months. Angiography showed that the right vertebral artery was hypoplastic and that the left vertebral artery was occluded at the C1-C2 level when the head was rotated to the right side. His severe vertigo was believed to be caused by blood flow insufficiency of the left vertebral artery which was occluded following head rotation to the right. Surgery was carried out via the anterolateral approach. The C2 cervical nerve had adhered strongly to the left vertebral artery which resulted in stenosis of the left vertebral artery on the head rotation to the right. The C2 nerve was transected and foraminotomy of the transverse foramina of the C1 and C2 was performed for decompression of the vertebral artery. The patent's complaint disappeared following the operation. Postoperative angiography revealed no stenosis of the left vertebral artery on the head rotation to the right.
日本脊髄外科学会の論文
2003-03-31