Vertebral Artery Compression of the Medulla

Savitz, Sean I; Ronthal, Michael; Caplan, Louis R.

doi:10.1001/archneur.63.2.234

Cited by 59 publications

(66 citation statements)

References 24 publications

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“…One surgical patient developed cranial nerve complications. Among the medically treated patients, none had progression of deficits, and those with single episodes had no recurrence of symptoms 13 . Krisht et al 17 reported their experience using the pretemporal, transzygomatic, transcavernous approach with 50 complex basilar aneurysms.…”

Section: Posterior Circulationmentioning

confidence: 92%

“…Except for the incidence of stroke, inaugural manifestations (stroke vs nervous compression) did not seem to influence the long-term prognosis 16 . Savitz et al 13 studied nine symptomatic patients (four men, five women, age range: 32-79 years) with medulla compression from the vertebral artery and found that compression most commonly occurs at the ventrolateral surface. The clinical features can be transient or permanent and are predominantly motor and cerebellar or vestibular, but a poor correlation exists between the clinical findings and the severity or extent of impingement.…”

Section: Posterior Circulationmentioning

confidence: 99%

“…Most arterial compressive lesions have been attributed to VBD and prior reports have concentrated mainly on the pressure effects of basilar artery ectasia. Much less is known about vertebral artery compression of the medulla 13 . We report here an asymptomatic case of a large ACoA fenestration associated with posterior circulation anomalies, including dolichoectasias.…”

Section: Introductionmentioning

confidence: 99%

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The �8 of Willis�: large anterior communicating artery fenestration associated with posterior circulation anomalies

Mavridis¹,

Anagnostopoulou²

2013

OA Case Reports

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Section: Posterior Circulationmentioning

confidence: 92%

Section: Posterior Circulationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The �8 of Willis�: large anterior communicating artery fenestration associated with posterior circulation anomalies

Mavridis¹,

Anagnostopoulou²

2013

OA Case Reports

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“…Expansion of the basilar artery can directly oppress medulla oblongata and pons, causing transient or persistent symptoms in movement like; weakness, dizziness, ataxia, tingling, tinnitus, hoarseness, dysphagia, slurred speech, headache, etc. It can also impair the apnea and cerebellar ataxia with symptoms which can range from mild to severe [12].…”

Section: Journal Of Neurology and Neurosciencementioning

confidence: 99%

Vertebral Artery Dolichoectasia with Fusiform Aneursym Presented By Internuclear Ophthalmoplegia: A Case Report

Şengeze¹,

Yürekli²

2016

J Neurol Neurosci

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Dolichoectasia is a term used to describe marked widening, tortuosity and elongation of an artery. Intracranial vertebral and basilar arteries are most commonly involved. Vertebrobasilar dolichoectasia is usually asymptomatic. Cranial nerve compression and cerebral ischemia findings are frequently seen in symptomatic patients. However, vertebrobasilar artery dolichoectasia with internuclear ophthalmoplegia (INO) clinical presentation has not been reported in literature yet. In our case, we report of a 67 year old female who had symptoms of diplopia, left abducens palsy and headache with no prior medical or family history of cerebrovascular disease. She has been presented with INO due to left vertebrobasilar dolichoectasia. Atypical presentation of INO is rare and vertebral artery dolichoectasia as the underlying aetiology, like in our case is even rarer and has not been seen in literature so far.

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“…Ischemic cerebral lesions of brain stem or cerebrum as seen in dysarthria-clumsy hand syndrome were excluded [4]. The brain stem vascular loop syndrome can be accompanied by neurological symptoms of time courses ranging from permanent deficits to TIA like events [1,5]. Consequently, explanations vary from compressive to ischemic lesion of the brain stem.…”

Section: Dear Sirsmentioning

confidence: 99%

Episodic dysarthria related to vascular medullary compression

Haubrich

Kleiser

Kosinski³

et al. 2009

J Neurol

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Dear Sirs,Episodic monomorphic complaints such as facial hemispasm, trigeminal neuralgia and typewriter tinnitus are considered pathognomonic for nerve-vessel-contact situations [1]. We present a case of episodic dysarthria as a manifestation of a vascular loop syndrome which has not been reported before. Oral informed consent was obtained from the patient prior to each examination as well as permission to publish the data.At time of admission, a 58 year-old, right-handed gentleman recurrently had brief episodes of slurred articulation during free conversation. Audio-file analysis revealed that dysarthric episodes were triggered during spontaneous speech, singing as well as reading aloud of a standardized text. Events had occurred periodically lasting 20 (±2) s and were followed by asymptomatic intervals of 84 (±10) s. During episodes, the intelligibility of his speech was reduced which affected his work as administrator of an insurance company. He reported a lack of control over articulation, ''as if being drunk'', and showed efforts to overcome his speech deficit. The dysarthric episodes were accompanied by hypomimic facial expression, and incidentally by mild motor disturbance of gait or handwriting. Between episodes articulatory precision and motor skills were all normal.Frenchay Dysarthria Assessment [2] revealed signs of a moderate to severe predominantly spastic dysarthria characterized by reduced intensity, monotonous prosody, strangled and harsh quality of voice, mild hypernasality, slowed articulation with many phonetic distortions and alterations (segment elisions, insertions, and feature changes). Dysarthric episodes occurred in all expressive language modalities: spontaneous speech, repetition, naming and reading aloud. The computerized analysis of the acoustic speech signal revealed that single word production was prolonged by over 30% due to insertion and prolongation of segments resulting in slurred articulation (Fig. 1a, b) [3]. There were marked difficulties to carry out rapid and alternating lip and tongue movements. Swallowing was not considered. Episodes of speech impairment were accompanied by right hand clumsiness and dysdiadochokinesia.At follow-up examination after 6 months, the patient still presented with episodic dysarthria which made him retire early from work. Episodes persisted with an average duration of 20 s, while the asymptomatic intervals eventually had been expanded to an average of 9 min.The neurophysiological examination included an electroencephalogram, sensory, transcranial magnetic, and Electronic supplementary material The online version of this article (

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Vertebral Artery Compression of the Medulla

Cited by 59 publications

References 24 publications

The �8 of Willis�: large anterior communicating artery fenestration associated with posterior circulation anomalies

The �8 of Willis�: large anterior communicating artery fenestration associated with posterior circulation anomalies

Vertebral Artery Dolichoectasia with Fusiform Aneursym Presented By Internuclear Ophthalmoplegia: A Case Report

Episodic dysarthria related to vascular medullary compression

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