ROTATIONAL VERTEBROBASILAR INSUFFICIENCY AS A COMPONENT OF THORACIC OUTLET SYNDROME RESULTING IN TRANSIENT BLINDNESS - CASE-REPORT

Cases of unilateral vertebral artery compression associated with thora cic outlet syndrome infrequently result in symptoms and, of those that do, most involve the brain stem. Reports of transient blindness resul ting from this condition are even more rare. The authors describe the case of a middle-aged woman who presented with transient blindness whe n she turned her head excessively to the left. She also exhibited othe r less severe brainstem symptoms. Arteriography demonstrated occlusion of the left vertebral artery only when her head was rotated to the le ft. Surgical exploration revealed entrapment of the left vertebral art ery by a tight anterior scalene muscle, release of which resulted in c omplete resolution of her symptoms. Both neurosurgeons and radiologist s need to be aware that extrinsic compression of the vertebral artery precipitated by head rotation may sometimes result in transient cortic al blindness.