寰椎后弓椎动脉沟环与颈性眩晕92例临床X线分析

目的：探讨寰椎后弓椎动脉沟环（下称后环）对颈性眩晕的关系．材料方法：从1000例颈椎摄片中，选出有后环的92例。体征通过转动头颈诱发椎动脉屈曲试验阳性，58例作脑血管多普勒（TCD）检查评估基底动脉供血情况，全部病例在电视下摄取颈椎正侧及双斜位片，分析后环的形态、大小及出现位置．结果：（1）完整环／孔46例。呈椭圆形者39例，近似圆形者7例，双侧着7例，左侧者19例，右侧着20例，不完整环46例。有3种X线变异型：上突骨、下突骨与吻状突骨．有颈椎退变者34例；无颈椎退变者58例．（2）后环与颈性眩晕无颈椎退变X线征象的58例（63％），TCD均提示基底动脉痉挛或供血不足，其中5例还出现单侧或双侧大脑中动脉血流下降，另8例经转头后才显示基底动脉供血不足。（3）临床主要以椎动脉型颈性眩晕者38例，颈一脑－臂综合症者54例．结论：后环的存在，对头颈的轴向旋转运动，可引起椎动脉V－3段痉挛与狭窄．导致脑底供血不足出现间歇性眩晕有密切关系。

Arcus Posterior Vertebral Artery Ring of Cervical Vertigo (Clinical and Radiologic Analysis of 92 Cases)

To evaluate the relations between the retroarcus vertebral artery ring (abbrevition:retro-ring)and the cervical vertigo.Materials and Methods:92 cases of retro-arcus vertebral artery ring of the atlas werestudied clinically and roentgenological,those were seen from 1,000 cases of the cervical roentgengraphy.The signs were positive in the flexed test of vertebral artery during rotation of the head and. 45 cased of those had beenchecked the basilar artery blood supply on the cerebrial vessel T. C. D. All cases were studies the shape, size andposition of the retro-ring on the plain frontal,lateral and oblique radiograms of cervicum,those were taken inperspective on the television.Results: (1) Roentgenolgical analysis of the retro-ring: of the 92 cases,there were 46cases of complete retro-ring,39 cases of those were oval, 7 were similar-circular,and 7 were in two sides,19 inthe left, 20 in the right.There were 46 cases of incomplete retro-ring,they could be subdiveded into upper pro-cess,lowr process and kissing process.34 cases showed x-ray signs of degenerative changes in the cervical spine,58 cases showed no signs of the cervical degenerative changes. (2) Analysis between the retro-ring and thecervical vertigo:In the 58 cases of no x-ray signs of the cervical degenerative changes,they suggested thebasilas insufficiency or the basilas artery spasm on the T. C. D., 5 cases of them were diminished the middlecerebral blood flow in one or two sides;and 8 showed the basilar insufficiency when rotation of the head. (3)Clinical symptoms and signs of 92 cases:38 cases were mainly seen in cervical vertigo of vertebra artery,54 cases in cervico -cephalobra- chialgic syndrome.Conclusion:Retro-ring might caused the spasm and strnosis of the vertebral artery at V-3 when rotation of the head and neck round an axis ,and the vertebrobasilar insufficiency were closely related to intermittent vertigo .