Rotational vertebral artery syndrome (original) (raw)

Rotational vertebral artery syndrome (RVAS) presents with attacks of vertigo, nystagmus, and tinnitus triggered by head rotation due to compression of the dominant vertebral artery (VA). This case study describes a patient with significant bilateral carotid stenosis experiencing RVAS symptoms, where three-dimensional kinematic analysis of nystagmus showed major downbeat components. Imaging revealed a hypoplastic right VA and altered arterial supply, suggesting acute vertebrobasilar insufficiency resulting in asymmetric ischemia. The findings indicate that RVAS may represent a vascular syndrome, which improved following bilateral carotid endarterectomy.