Hemiparesis caused by vertebral artery compression of the medulla oblongata

Kim, Phyo; Ishijima, Buichi; Takahashi, Hiroshi; Shimizu, Hiroyuki; Yokochi, Masayuki

doi:10.3171/jns.1985.62.3.0425

Cited by 40 publications

(25 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2) Placement of a prosthesis between the artery and spinal cord is another procedure to reduce vascular decompression and is currently the preferred treatment for hemifacial spasm and trigeminal neuralgia. 4) However, this method does not ensure decompression of the cervical cord because the offending vessels are large, and so the symptoms may progress postoperatively. We emphasize that mobilization of the artery and anchoring to the dura is probably the most effective treatment.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Cervical Myelopathy Due to Compression by Bilateral Vertebral Arteries. Case Report.

Takahashi

Sugita

Uchikado

et al. 2001

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

A 69-year-old man presented with progressive cervical myelopathy due to vascular compression of the upper cervical spinal cord. Vertebral angiography and magnetic resonance imaging revealed that the elongated bilateral vertebral arteries (VAs) had compressed the spinal cord at the C-2 level. The spinal cord was surgically decompressed laterally by retracting the VAs with Gore-Tex tape and anchoring them to the dura. The patient's symptoms improved postoperatively. Decompression and anchoring of the causative vessels is recommended due to the large size of the VAs.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Neurovascular compression of the medulla oblongata can cause hemiparesis, 3,4) which may be associated with hypertension. However, cervical myelopathy caused by neurovascular compression is rare, with only five cases of cervical myelopathy due to vascular compression of the upper cervical spinal cord.…”

Section: Introductionmentioning

confidence: 99%

Cervical Myelopathy Due to Compression by Bilateral Vertebral Arteries. Case Report.

Takahashi

Sugita

Uchikado

et al. 2001

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

show abstract

“…Levine et al previously reviewed literature and showed that in 128 patients, 58% experienced cranial nerve compression, most of them complaining about facial spasm and trigeminal neuralgia, 48% experienced vertebrobasilar insufficiency or stroke or both, 31% had hydrocephalus and only 24% had symptoms and signs from brain-stem compression 16 . Kim et al, in 1985, were the first to report brainstem dysfunction caused by vascular compression 17 . Experimental studies have shown that rapid mechanical compression of the brainstem induces immediate damage, and this is directly proportional to the degree of compression.…”

Section: Discussionmentioning

confidence: 99%

Brainstem compression syndrome caused by vertebrobasilar dolichoectasia: microvascular repositioning technique

Pereira-Filho

Faria

Bleil

et al. 2008

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

Vertebrobasilar dolichoectasia (VBD) is an anatomic variant that consists of enlargement and dilatation, often associated with a tortuous and elongated vessel 1 . The anomaly is probably due to a marked thinning of the internal elastica lamina and media, most likely as a consequence of prolonged systemic arterial hypertension 2 . It accounts for approximately 3 to 5% of all cerebellopontine mass lesions. A variety of clinical syndromes have been related due to pulsatile compression by the aberrant vessel: cerebellar dysfunction, hydrocephalus, ischemic stroke, transient or permanent motor deficits, central sleep apnea, trigeminal neuralgia, as well as brain stem compression syndrome 1,3,4 . Microvascular decompression surgery was introduced in the 1960s and was initially used to treat trigeminal neuralgia, hemifacial spasm and glossopharyngeal neuralgia 5 . Lately, it was used to treat brainstem dysfunction caused by an ectatic vessel 1 . Nowadays, microvascular decompression with repositioning of the ectatic vessel is a new technique that has been used successfully.The purpose of this study is to report and discuss a rare case of brain stem compression syndrome caused by vertebrobasilar dolichoectasia successfully treated with microvascular decompression repositioning technique and documented by computed tomography angiography (CTA) and magnetic resonance imaging (MRI). CASEA 60-years old man with a past medical history of diabete mellitus type 2 sought neurological treatment after experiencing mild progressive disartria for eight months. He did not have other complaints. The patient's neurologial examination revealed, besides the speech abnormality, left side pyramidal syndrome with hiperreflexia and Babinski´s sign. All the other aspects of the neurological examination were intact. Imaging investigationMRI and CTA showed an elongated and tortuous vertebrobasilar artery that crossed the ventral aspect of the medulla oblongata causing mechanial compression at the left side (Figs 1 and 2). Surgical techniqueThe patient was placed in the prone oblique (park bench) position, and a left far lateral suboccipitoretromastoidea approach was performed with left vertebral artery exposure. The dura was opened, and cerebrospinal fluid was released at the cisterna magna to provide a capacious working environment.Arachnoid dissection revealed a large vascular structure, identified as the basilar dolichoectatic artery, dislocating and compressing the brain stem (medulla oblongata) in its left ventral region. As soon as the neurovascular conflicting area was

show abstract

“…Tortuosity of the VA, in particular, has been shown to produce extradural cervical radiculopathy as well as intradural brainstem dysfunction by direct compression. 1,6,7,[9][10][11][12][13][17][18][19][20]23,25,29,30 Such tortuosity has been observed postmortem in anatomical studies, as well as in vivo on radiography, MRI, or via traditional angiography. 2,5,28,35 Classically, Jannetta linked vascular compression of the trigeminal nerve to trigeminal neuralgia, and showed that microvascular decompression of the affected nerve could produce symptomatic relief.…”

Section: Discussionmentioning

confidence: 99%

Microvascular decompression of a C-2 segmental-type vertebral artery producing trigeminal hypesthesia

Sellin

Al-Hafez²,

Duckworth³

2014

JNS

View full text Add to dashboard Cite

The authors report a case of trigeminal hypesthesia caused by compression of the spinal cord by a C-2 segmental-type vertebral artery (VA) that was successfully treated with microvascular decompression. Aberrant intradural VA loops have been reported as causes of cervical myelopathy, some of which improved with microvascular decompression. A 52-year-old man presented with progressive complaints of headache, dizziness, left facial numbness, and left upper-extremity paresthesia that worsened when turning his head to the right. Magnetic resonance imaging of the cervical spine showed the left VA passing intradurally between the axis and atlas, foregoing the C-1 foramen transversarium, and impinging on the spinal cord. The patient underwent left C-1 and C-2 hemilaminectomies followed by microvascular decompression of an aberrant VA loop compressing the spinal cord. The patient subsequently reported complete resolution of symptoms.

show abstract

Hemiparesis caused by vertebral artery compression of the medulla oblongata

Cited by 40 publications

References 15 publications

Cervical Myelopathy Due to Compression by Bilateral Vertebral Arteries. Case Report.

Cervical Myelopathy Due to Compression by Bilateral Vertebral Arteries. Case Report.

Brainstem compression syndrome caused by vertebrobasilar dolichoectasia: microvascular repositioning technique

Microvascular decompression of a C-2 segmental-type vertebral artery producing trigeminal hypesthesia

Contact Info

Product

Resources

About