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Case Reports in Medicine
Volume 2012 (2012), Article ID 894913, 3 pages
Case Report

The Diagnosis of Vertebrobasilar Insufficiency Using Transcranial Doppler Ultrasound

1Division of Neurosurgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada T6G 2B7
2Division of Neurosurgery, Department of Surgery, King Khalid University, P.O. Box 641, Abha, Saudi Arabia
3Division of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada T6G 2B7

Received 9 August 2012; Revised 17 October 2012; Accepted 18 October 2012

Academic Editor: Bruno Megarbane

Copyright © 2012 Ibrahim Alnaami et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Vertebrobasilar insufficiency (VBI) is a hemodynamic posterior circulation transient ischemic attack (TIA) caused by intermittent vertebral artery occlusion that is induced by a head rotation or extension. VBI may result from large vessel atherosclerotic disease, dissection, cervical compressive lesions, and subclavian steal phenomenon. Diagnostic transcranial Doppler (TCD) of VBI disease and hemodynamic posterior circulation TCD monitoring in symptomatic positions might prove a useful tool in establishing the diagnosis. Patient and Material/Method. A 50-year-old Caucasian man presented with a one-year history of episodic positional vertigo and ataxic gait that were induced by a neck extension and resolved by an upright position or a neck flexion. Computed tomography angiogram (CTA) and TCD confirmed the presence of VBI where no blood flow was detected through posterior cerebral arteries in the symptomatic position (head extension position). Conclusion. TCD is a promising noninvasive technique that might have a role as a diagnostic test in VBI.