Nerve Compression Syndromes in the Posterior Cranial Fossa

Baldauf, Jörg; Rosenstengel, Christian; Schroeder, Henry W. S.

doi:10.3238/arztebl.2019.0054

Cited by 19 publications

(24 citation statements)

References 74 publications

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“…The pathophysiology mechanisms of these NVCSs are similar, which includes demyelination induced by pressure and ectopic generation and ephaptic transmission of the impulses along the compressed nerve 121 , 149 . The diagnosis of these diseases mainly depends on specific clinical manifestations and MRI evidence.…”

Section: Neurovascular Compression Syndromementioning

confidence: 99%

Clinical Importance of the Posterior Inferior Cerebellar Artery: A Review of the Literature

Miao¹,

Zhang²,

Wang³

et al. 2020

Int. J. Med. Sci.

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The posterior inferior cerebellar artery (PICA), with its unique anatomical complexity, is of great clinical importance and involved in many diseases including aneurysm, ischemic stroke, neurovascular compression syndrome (NVCS), arteriovenous malformation (AVM), and brain tumor. However, a comprehensive systematic review of the importance of the PICA is currently lacking. In this study, we perform a literature review of PICA by searching all the associated papers in the PUBMED database hoping to provide a better understanding of the artery. The PICA has tortuous and variable course and territory, divided into 5 segments. Various aneurysms involving PICA were not uncommon, of which the treatment is challenging. The PICA infarct typically manifests lateral medullary syndrome (LMS) and is more likely to cause mass effects. The PICA frequently compresses the medulla and the cranial nerves resulting in various neurovascular compression syndromes (NVCS). Arteriovenous malformation (AVM) fed by PICA are associated with aneurysm and dissection which have high risk of rupture and worse outcome. PICA injured by head trauma can cause fatal SAH. VA terminating in PICA probably cause Bow hunter's syndrome (BHS). The PICA supplies many brain tumors and can be used in intracerebellar chemotherapy. The PICA can be exposed and injured during surgeries especially in telovelar approach, and it also plays an important role in bypass surgeries, hinting the surgical importance of PICA. In conclusion, PICA is very important in clinical practice.

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Section: Neurovascular Compression Syndromementioning

confidence: 99%

Clinical Importance of the Posterior Inferior Cerebellar Artery: A Review of the Literature

Miao¹,

Zhang²,

Wang³

et al. 2020

Int. J. Med. Sci.

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show abstract

“…MVD is a popular treatment for NVCs. [1] Arteries of posterior fossa such as the VA, and PFIA is one of the most common VA variations at the C1-C2 level, may be responsible for NVCs in a few cases. [2,3,6,7] ese anomalies/tortuosities are most frequently detected on MR (3.2%); they occasionally form bilateral fenestrations.…”

Section: Discussionmentioning

confidence: 99%

A case report of microvascular decompression for cervical myelopathy and radiculopathy caused by tortuous and abnormal bilateral vertebral artery

Omura¹,

Park²,

Ikeda³

et al. 2020

Surgical Neurology International

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Background: Tortuous/abnormal vertebral arteries (VAs) sometimes cause neurovascular compression syndromes (NVCs), such as trigeminal neuralgia, hemifacial spasm, and, rarely, myelopathy/radiculopathy. Abnormalities/tortuosity of the VA at the level of the atlas and axis are of particular note; these may be characterized by a persistent first intersegmental artery (PFIA) and C2 segmental type of VA. Herein, we report a 72-year-old male who presented with cervical myelopathy/radiculopathy due to bilateral tortuosity of the PFIA resulting in spinal cord compression at the craniocervical junction. Case Description: A 72-year-old male presented with cervical pain when turning his neck and progressive gait disturbance. The neurological examination demonstrated a moderate myeloradicular syndrome (Nurick Grade III). The magnetic resonance revealed compression of the medulla and spinal cord due to tortuosity of both dorsal VA at the C1 vertebral level. The three-dimensional computed tomography angiogram confirmed bilateral PFIA running medially. In addition, the left side of VA forms fenestration. Surgery through a C1 laminectomy and midline small suboccipital craniectomy, both VAs were transposed and tethered to the ipsilateral dura utilizing Aron Alpha and vinyl prostheses. In addition, a large vinyl prosthesis was inserted between both VAs to protect them from contacting the spinal cord. Following this decompressive procedure, the patient’s symptoms fully resolved, and he remains asymptomatic 10 years later exhibiting no recurrent vascular pathology. Conclusion: Microvascular decompression of anomalous VAs contributing to cord compression at the C1 level was safe and effective in a 72-year-old male.

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“…Neural vascular conflict (NVC) of the cerebellopontine angle is considered a rare cause of SSD among children, which can affect the V, VII, VIII, and IX cranial nerves. The commonest presenting symptom of NVC is trigeminal neuralgia, and next to that is hemifacial spasm [6]. Neural vascular conflict of the VIII nerve may provoke symptoms of tinnitus, hearing loss, and vertigo as neurotological symptoms.…”

Section: Introductionmentioning

confidence: 99%

Single-sided deafness related to neural vascular conflict: A case report from Saudi Arabia

Mona¹

2020

Int J Case Rep Images

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The impact of single-sided deafness (SSD) is well known, particularly on children. These include difficulties in speech comprehension with background noise, localization, and spatial appreciation. The social and emotional status of the child may be compromised. In addition, parents are keen to understand the etiology and consequences of SSD. Different etiologies are correlated with SSD, and etiology identification is a crucial step toward better management and parent counseling. SSD related to neural vascular conflict (NVC) of the cerebellopontine angle is uncommon. This is the first case, up to my knowledge so far, to be reported in Saudi Arabia. A 13-year-old Saudi girl presented with a history of difficulty in hearing in the left ear, and audiological evaluation demonstrated left-sided profound sensorineural hearing loss. Upon further investigation, magnetic resonance imaging (MRI) showed a left-sided neural vascular conflict of the anterior inferior cerebellar artery (AICA) loop and the left cochlear nerve. In this case, SSD was related to NVC since clinical history, and other investigations did not justify another cause. This report will embrace the role of audiological and radiological investigation, which in turn will help with management recommendations, and help clinicians in dealing with similar challenges.

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Nerve Compression Syndromes in the Posterior Cranial Fossa

Cited by 19 publications

References 74 publications

Clinical Importance of the Posterior Inferior Cerebellar Artery: A Review of the Literature

Clinical Importance of the Posterior Inferior Cerebellar Artery: A Review of the Literature

A case report of microvascular decompression for cervical myelopathy and radiculopathy caused by tortuous and abnormal bilateral vertebral artery

Single-sided deafness related to neural vascular conflict: A case report from Saudi Arabia

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