Cervicogenic vertigo was known as Bow hunter's syndrome. Occlusion of vertebral artery causes vertebrobasilar insufficiency and we reported cervicogenic vertigo case which was treated by simple decompression of transverse foramen of C1. The patient was 48 years old female who had left side dominant vertebral artery and vertigo was provoked when she rotated her head to right side. Angiography showed complete obliteration of blood flow of left vertebral artery when her head was rotated to right side. The operation was decompression of left vertebral artery at C1 level. Posterior wall of transverse foramen was resected and vertebral artery was exposed and decompressed. After surgery, vertigo of the patient was disappeared, and angiography showed patent left vertebral artery when her head was rotated to right side. Vertigo caused by compression of cervical vertebral artery could be treated by decompression without fusion or instrumentation, especially in C1 transverse foramen.
Angiography ; Decompression* ; Female ; Head ; Humans ; Mucopolysaccharidosis II ; Vertebral Artery ; Vertebrobasilar Insufficiency ; Vertigo*

PURPOSE: Neurologic deficits after enucleation of schwannoma are not rare. To evaluate the neurologic deficits after surgical enucleation of schwannoma in the upper extremity, we performed a retrospective review of patients with surgically treated schwannoma over a 14-year period at a single institution. METHODS: Between March 2001 and September 2014, 103 patients underwent surgical enucleation for schwannomas; 36 patients of them had lesions in the upper extremity, and 2 out of 36 patients had multiple schwannomas. Each operation was performed by a single surgeon under loupe magnification. The postoperative neurological deficits were graded as major and minor in both immediate postoperatively and at last follow-up. The major deficit was defined as anesthesia or marked hypoesthesia, motor weakness of grade 3 or less and neuropathic pain. Minor deficit was defined as mild symptoms of mild hypoesthesia, paresthesia and motor weakness of grade 4 or more. RESULTS: There were 2 major (2 mixed nerve) and 12 minor (4 motor, 7 sensory, 1 mixed nerve) neurologic deficits after surgery. At the last follow-up, one major mixed neurologic deficit remained as major motor and minor sensory, and other major ones changed to mixed minor. And all minor deficits except 1 sensory deficit were recovered spontaneously. CONCLUSION: Even though high incidence rate of neurologic deficit after enucleation of schwannoma in the upper extremity (38.9%), about three fourths of them were recovered spontaneously. There were 3 permanent neurologic deficits, and one of them was major one. In some cases, surgeon cannot avoid to encounter a neurological deficit. So we recommend more delicate microscopic surgical procedure and preoperative planning and counseling. And surgery is indicated for only symptomatic lesions.
Anesthesia ; Counseling ; Follow-Up Studies ; Humans ; Hypesthesia ; Incidence ; Neuralgia ; Neurilemmoma* ; Neurologic Manifestations* ; Paresthesia ; Retrospective Studies ; Upper Extremity*