Isolated pathetick nerve paresis by compression from a dolichoectatic basilar artery: case report

Maranhão-Filho, Péricles; Souto, Antonio Aversa Dutra do; Nogueira, Janio

doi:10.1590/s0004-282x2007000100038

Cited by 7 publications

(3 citation statements)

References 14 publications

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“…These VBD patients obtained good therapeutic effects with microvascular decompression treatment 34. In addition, VBD can also compress the abducens nerve 36, trochlear nerve 37, and oculomotor nerve 38. Other nerve compression symptoms such as nystagmus 39, tinnitus 40, hoarseness, and difficulty swallowing 41 have been reported.…”

Section: Clinical Manifestationsmentioning

confidence: 80%

Research Progress on Vertebrobasilar Dolichoectasia

Yuan¹,

Xu²,

Luo³

et al. 2014

Int. J. Med. Sci.

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Vertebrobasilar dolichoectasia (VBD) is a rare disease characterized by significant expansion, elongation, and tortuosity of the vertebrobasilar arteries. Current data regarding VBD are very limited. Here we systematically review VBD incidence, etiology, characteristics, clinical manifestations, treatment strategies, and prognosis. The exact incidence rate of VBD remains unclear, but is estimated to be 1.3% of the population. The occurrence of VBD is thought to be due to the cooperation of multiple factors, including congenital factors, infections and immune status, and degenerative diseases. The VBD clinical manifestations are complex with ischemic stroke as the most common, followed by progressive compression of cranial nerves and the brain stem, cerebral hemorrhage, and hydrocephalus. Treatment of VBD remains difficult. Currently, there are no precise and effective treatments, and available treatments mainly target the complications of VBD. With the development of stent technology, however, it may become an effective treatment for VBD.

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Section: Clinical Manifestationsmentioning

confidence: 80%

Research Progress on Vertebrobasilar Dolichoectasia

Yuan¹,

Xu²,

Luo³

et al. 2014

Int. J. Med. Sci.

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“…The most common symptoms are trigeminal neuralgia and hemifacial spasm caused by pulsatile compression of the trigeminal nerve root (Fig 10) and facial nerve root (25,(61)(62)(63) (Figs 11, 12). Other symptoms include nystagmus, tinnitus, and hearing loss from compression of the vestibulocochlear nerve or nerve root entry (64,65) (Fig 13); visual loss and homonymous hemianopia from compression of the optic nerve (66); diplopia and Horner syndrome related to compression of the abducent, trochlear, or oculomotor nerves (67)(68)(69); and hoarseness and dysphagia related to compression of the medullary pyramids (70).…”

Section: Compressive Symptomsmentioning

confidence: 99%

Multimodality Imaging of Vertebrobasilar Dolichoectasia: Clinical Presentations and Imaging Spectrum

Samim¹,

Goldstein²,

Schindler³

et al. 2016

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Vertebrobasilar dolichoectasia (VBD) is characterized by ectasia, elongation, and tortuosity of the vertebrobasilar arteries, with a high degree of variability in clinical presentation. The disease origin is believed to involve degeneration of the internal elastic lamina, thinning of the media secondary to reticular fiber deficiency, and smooth muscle atrophy. The prevalence of VBD is variable, ranging from 0.05% to 18%. Most patients with VBD are asymptomatic and their VBD is detected incidentally; however, it is important to recognize that the presence of symptoms, which can lead to clinically significant morbidity and sometimes mortality, may influence clinical management. The most important clinical presentations of VBD are vascular events, such as ischemic stroke and catastrophic intracranial hemorrhage, or progressive compressive symptoms related to compression of adjacent structures, including the cranial nerves, brainstem, or third ventricle, causing hydrocephalus. The imaging diagnostic criteria for computed tomography and magnetic resonance (MR) imaging include three quantitative measures of basilar artery morphology: laterality score, height of bifurcation, and basilar artery diameter. The authors review the relevant anatomy and disease origin of VBD; pertinent imaging findings, including intraluminal thrombus and relation to the cranial nerves; and imaging pitfalls, such as the hyperintense vessel sign on MR images and artifacts related to slow flow in the dolichoectatic vessel. In addition, clinical manifestations, the role of radiology in diagnosis and management of this condition, and available management options are reviewed. (©)RSNA, 2016.

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“…The pressure effects of VBD can also directly compress the brainstem and cranial nerves, most commonly the trigeminal nerve and facial nerve, resulting in trigeminal neuralgia and hemifacial paralysis [ 23 , 24 ]. Less commonly, VBD can compress the abducens nerve [ 25 ], the trochlear nerve [ 26 ], and the oculomotor nerve [ 27 ]. Compression of the lower brainstem can lead to nystagmus [ 28 ], tinnitus [ 29 ], hoarseness, and difficulty in swallowing [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Acute Bilateral Ophthalmoplegia Due to Vertebrobasilar Dolichoectasia: A Report of Two Cases

et al. 2017

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Case seriesPatient: Male, 52 • Female, 68Final Diagnosis: VBDSymptoms: OphthalmoplegiaMedication: —Clinical Procedure: —Specialty: NeurologyObjective:Unusual clinical courseBackground:Vertebrobasilar dolichoectasia (VBD) is a complex progressive arterial disease characterized by dilation, elongation, and tortuosity of the vertebral and basilar arteries, and may be congenital or acquired. VBD may lead to progressive compression of the brainstem, cranial nerve abnormalities, and intracranial hemorrhage, but may also be associated with arterial thrombosis, with ischemic stroke as the most common clinical outcome.Case Report:Two cases of VBD are presented, both with acute bilateral ophthalmoplegia and cranial nerve palsies, and vertebrobasilar arterial thrombosis that resulted in ischemic stroke.Conclusions:VBD is a complex arterial disease with a variety of clinical manifestation, with bilateral ophthalmoplegia being a rare presentation. Clinical management of VBD is a challenge as there are no current management guidelines. Therefore, clinical management of cases of VBD should be individualized to balance the risks and benefits of treatment options for each patient.

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Isolated pathetick nerve paresis by compression from a dolichoectatic basilar artery: case report

Cited by 7 publications

References 14 publications

Research Progress on Vertebrobasilar Dolichoectasia

Research Progress on Vertebrobasilar Dolichoectasia

Multimodality Imaging of Vertebrobasilar Dolichoectasia: Clinical Presentations and Imaging Spectrum

Acute Bilateral Ophthalmoplegia Due to Vertebrobasilar Dolichoectasia: A Report of Two Cases

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