Abstract
Cervical spondylitic spurs can cause impairment of vertebral artery blood flow, thus producing the clinical picture of vertebral artery insufficiency. The fifty-four year old man described herein had severe recurrent headaches, and angiography demonstrated impairment of left vertebral artery blood flow by a large cervical osteophyte. Cervical spinal fusion resulted in clinical remission for four years. The anatomic relationships of the vertebral arteries which predispose them to compression and trauma are discussed. The resulting neurologic symptoms and signs are similar to those occurring with basilar artery insufficiency. They are frequently episodic and are associated with certain postures of the head and neck. Angiographic study should include visualization of all four cervical arteries, with the neck held in flexion and hyperextension, and with the head turned to both sides. Surgical intervention is indicated when symptoms are frequent and severe, and consists of decompression of the vertebral artery and/or cervical spinal fusion.
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