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Clinical and Doppler examination of 146 patients was carried out young age (18-44 years, including men - 75, women - 71) with cervicogenic headache. All patients were divided into two clinical groups: group 1 - cervicocranialgia - 82 patients; group 2 - posterior cervical sympathetic Barre-Lieou syndrome - 64 patients. By help triplex transcranial scanning has been studied high- speed blood flow indicators in the supraocular and vertebral veins, basal veins of Rosenthal, sinus rectus, as well as reactivity coefficients in the vertebral veins, basal veins of Rosenthal and direct sinus at applications and orthostatic and antiorthostatic functional loads. All patients were determined Doppler and signs of cerebral venous dyscirculation, mainly in the vertebral veins. Signs of venous dyscirculation were manifested in the vertebral veins and sinus rectus in patients with cervicocranialgia, as well as in vertebral veins in patients with Barre-Lieou syndrome. Leading pattern there was a violation of autoregulation of cerebral venous blood flow hyporeactivity to orthostatic and antiorthostatic loading in the vertebral veins, more pronounced in patients with cervicocranialgia. Easy hyperreactivity to antiorthostatic load on the basal veins of Rosenthal and sinus rectus in patients of both groups indicates a violation of the neurogenic mechanism in the regulation of venous blood flow. [ABSTRACT FROM AUTHOR]

Abstract Background Ponticulus posticus (PP) occurs frequently and may cause symptom series, including vertebrobasilar insufficiency, migraine, hearing loss, and Barré‐Liéou syndrome. However, few studies to date have described surgical treatment of PP. We report a rare case of a patient who suffered from torticollis, facial asymmetry, localized pain, and Barré‐Liéou syndrome in connection with PP. We also review the pertinent literature, focusing on surgical treatment for symptoms due to PP. Case presentation A 23‐year‐old male presented with the chief complaint of continuous significant dizziness to the point of losing consciousness while rotating his head to the right. Plain radiographs and computed tomography (CT) scans of the cervical spine showed a С1 anomaly with the formation of complete PP on the left (dominant) side, with acute‐angled, С‐shaped kinking of the vertebral artery. Resection of PP via the posterior midline was performed successfully. The patient had satisfactory postoperative relief from localized pain and Barré‐Liéou syndrome, but there were no obvious changes in the torticollis and facial asymmetry observed during the 3‐month follow‐up period. Conclusions This case is a rare presentation of torticollis, facial asymmetry, localized pain, and Barré‐Liéou syndrome in connection with one‐sided complete PP. This tetrad indicates that PP may affect the patient earlier than expected. In such situations, early diagnosis and timely surgical treatment may significantly improve patients' quality of life and avoid the development of torticollis and face asymmetry.

Background: Ponticulus posticus (PP) occurs frequently and may cause symptom series, including vertebrobasilar insufficiency, migraine, hearing loss, and Barré‐Liéou syndrome. However, few studies to date have described surgical treatment of PP. We report a rare case of a patient who suffered from torticollis, facial asymmetry, localized pain, and Barré‐Liéou syndrome in connection with PP. We also review the pertinent literature, focusing on surgical treatment for symptoms due to PP. Case presentation: A 23‐year‐old male presented with the chief complaint of continuous significant dizziness to the point of losing consciousness while rotating his head to the right. Plain radiographs and computed tomography (CT) scans of the cervical spine showed a С1 anomaly with the formation of complete PP on the left (dominant) side, with acute‐angled, С‐shaped kinking of the vertebral artery. Resection of PP via the posterior midline was performed successfully. The patient had satisfactory postoperative relief from localized pain and Barré‐Liéou syndrome, but there were no obvious changes in the torticollis and facial asymmetry observed during the 3‐month follow‐up period. Conclusions: This case is a rare presentation of torticollis, facial asymmetry, localized pain, and Barré‐Liéou syndrome in connection with one‐sided complete PP. This tetrad indicates that PP may affect the patient earlier than expected. In such situations, early diagnosis and timely surgical treatment may significantly improve patients' quality of life and avoid the development of torticollis and face asymmetry. [ABSTRACT FROM AUTHOR]