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Original Article

Vestibular Symptoms Provoked by Head and Neck Rotation After Bilateral Carotid Ligation

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Pages 49-54 | Received 15 Jun 1965, Published online: 08 Jul 2009
 

Abstract

In a 53-year-old woman ligation of both common carotid arteries resulted in vestibular symptoms provoked by neck torsion. These symptoms were not present before the operations. Eleetronystagmography before the ligations showed no nystagmus but neck torsion afterwards provoked nystagmus, whereas positional tests without rotation of the neck gave no nystagmus. It is concluded that a vestibular test with eleetronystagmography before carotid or vertebral artery ligation might be used as a functional test on the circulation in the posterior communicating arteries in the circle of Willis. If neck torsion gives vestibular symptoms this circulation may not compensate adequately for vestibular ischaemia. The pre-operative vertebral angiogram and pre- and postoperative electronystagmography in the present case appear to support this hypothesis.

Bei einer 53jährigen Fran entwickeltcn sich nach finer Kopfverletzung bilate-rale karotid-kavernöse Fisteln. Nach Ligatur beider Kopfschlagadern verschwan-dcn die meisten Symptome, aber es entwickelten sich Zeichen von vestibularer Funktionsstörung. Bei Reclits- Oder Linksbewegung des Kopfes klagte die Pa-tientin über Schwindel, der aber bei Rüekbewegung des Kopfes in die Sagit-talebene sofort verschwand. Ein Vergleich der Elektronystagmogramme vor und nach dem Eingriff zeigte, dass der postoperative Schwindel durch einen nach Halsdrehung gestörten Blutzufluss in der Arteria vertebralis erklärt werden konnte. Nystagmographie von karotider Ligatur kann die durch Angiographic gewonnenen Datcn über den Blutzufluss in den Verbindungsschlagadern ini Oirculus Willisii ergänzen.

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