Subscribe to RSS
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.1055/s-0042-1758395
The Sistine Chapel and clothesline signs: a tale of two arteries
O sinal da Capela Sistina e sinal do varal: um conto sobre duas artérias![](https://www.thieme-connect.de/media/10.1055-s-00054595/202211/lookinside/thumbnails/10-1055-s-0042-1758395_220101-1.jpg)
An 83-year-old woman presented sudden vertigo, drop attack, and transient dysarthria after head hyperextension to see the Sistine Chapel ceiling, in the Vatican. Transcranial doppler ultrasound ([Figure 1]) suggested proximal basilar stenosis, confirmed by arteriography ([Figure 2]). Case 2: A 77-year-old woman presented a 1-year history of transient vertigo after hanging clothes on a clothesline. Transcranial doppler ultrasound ([Figure 3]) revealed left subclavian artery steal phenomenon secondary to proximal subclavian artery stenosis, confirmed by arteriography ([Figure 4]). They received stenting and dual antiplatelet therapy. Transient ischemic symptomatology triggered by head/neck and arm movements demands vertebrobasilar and subclavian evaluation.[1] [2] [3]
![](https://www.thieme-connect.de/media/10.1055-s-00054595/202211/thumbnails/10-1055-s-0042-1758395-i220101-1.jpg)
![Zoom Image](/products/assets/desktop/css/img/icon-figure-zoom.png)
![](https://www.thieme-connect.de/media/10.1055-s-00054595/202211/thumbnails/10-1055-s-0042-1758395-i220101-2.jpg)
![Zoom Image](/products/assets/desktop/css/img/icon-figure-zoom.png)
![](https://www.thieme-connect.de/media/10.1055-s-00054595/202211/thumbnails/10-1055-s-0042-1758395-i220101-3.jpg)
![Zoom Image](/products/assets/desktop/css/img/icon-figure-zoom.png)
![](https://www.thieme-connect.de/media/10.1055-s-00054595/202211/thumbnails/10-1055-s-0042-1758395-i220101-4.jpg)
![Zoom Image](/products/assets/desktop/css/img/icon-figure-zoom.png)
Authors' Contributions
LC: Organization and execution of the research project, writhing of the first draft and of the final manuscript; JMTM, ERO, CEFM, JCS, JAM, VHFZ, MCL, CAE, PCES: organization and execution of the research project, writing of the first draft of the manuscript; HAGT: conception of the research project, review and critique, writing of the final manuscript.
Publication History
Received: 08 May 2022
Accepted: 15 June 2022
Article published online:
28 December 2022
© 2022. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
-
References
- 1 Go JA, Al Othman B, Kini A, Beaver HA, Lee AG. Vertebrobasilar ischemia (VBI) related neuro-ophthalmic syndromes after routine activities involving hyperextension or rotation of the neck (hairdresser syndrome). Eye (Lond) 2020; 34 (05) 901-905
- 2 Savitz SI, Caplan LR. Vertebrobasilar disease. N Engl J Med 2005; 352 (25) 2618-2626
- 3 Kargiotis O, Siahos S, Safouris A, Feleskouras A, Magoufis G, Tsivgoulis G. Subclavian steal syndrome with or without arterial stenosis: A review. J Neuroimaging 2016; 26 (05) 473-480