Episodic vertigo resulting from vascular risk factors, cervical spondylosis and head rotation: Two case reports

Mayowa O Owolabi¹, Okechukwu S Ogah², Adesola Ogunniyi³

¹Department of Medicine, University College Hospital, PMB 5116, 200001, Ibadan, Nigeria; ²Federal Medical Center, Idi-Aba, Abeokuta, PMB 3031 Sapon PO, Abeokuta, Ogun State, Nigeria; ³Neurology Unit, Department of Medicine, University College Hospital, Ibadan, Nigeria

Background: Vascular risk factors predispose to vertebrobasilar ischemia. Cervical osteophytes can impinge on the vertebral artery causing mechanical occlusion during head turning. Presentation with vertigo in such instances is a common finding.

Case presentation: A patient with obesity, hyperlipidemia, hypertension, cervical spondylosis, and vertigo triggered by head rotation is presented. She responded to antihypertensive and lipid-lowering drugs, vestibular sedative and application of cervical collar. The second patient also exhibited similar features and responded to conservative treatment.

Discussion and conclusions: Rotational vertebral artery occlusion resulting from cervical spondylosis in the presence of atherosclerosed collateral vessels is a cause of posterior circulation insufficiency manifesting as vertigo. The tetrad of vertigo resulting from vascular risk factors, cervical spondylosis, and head rotation is proposed for further research.

Keywords: cervical, vertigo, spondylosis, vertebrobasilar insufficiency