Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-08T06:02:46.885Z Has data issue: false hasContentIssue false

Vascular cross-compression of the Vllth and VIIIth cranial nerves

Published online by Cambridge University Press:  29 June 2007

Naoki Ohashi*
Affiliation:
Departments of OtolaryngologyToyama Medical and Pharmaceutical University, Toyama, Japan.
Satsuki Yasumura
Affiliation:
Departments of OtolaryngologyToyama Medical and Pharmaceutical University, Toyama, Japan.
Hajime Nakagawa
Affiliation:
Departments of OtolaryngologyToyama Medical and Pharmaceutical University, Toyama, Japan.
Kanemasa Mizukoshi
Affiliation:
Departments of OtolaryngologyToyama Medical and Pharmaceutical University, Toyama, Japan.
Shougo Kuze
Affiliation:
Departments of Anaesthetics, Toyama Medical and Pharmaceutical University, Toyama, Japan.
*
Naoki Ohashi, M.D., MRC Human Movement and Balance Unit, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, U.K.

Abstract

A 53-year-old male patient had been suffering from severe aural symptoms (pulsatile right-sided tinnitus and paroxysmal dizziness attacks with nausea) and right hemifacial spasm. Treatment had involved stellate ganglion block with lignocaine and the injection of intravenous sodium bicarbonate solution for attacks of Meniere's syndrome and facial nerve block with lidocaine for hemi-facial spasm. Despite these treatments, the dizzy attacks became more frequent, developing into the clustering state. Air CT cisternography and vertebral angiography demonstrated an enlarged and curved vertebral artery. Vascular cross-compression of the Vllth and VHIth cranial nerves was therefore suspected. Microvascular decompression was performed. After operation, the pulsatile tinnitus, dizziness and hemifacial spasm disappeared. From the present case and a review of the literature, we conclude that vascular cross-compression of the VHIth cranial nerve should be an indication for microvascular decompression only when symptoms of vascular cross-compression of the Vllth cranial nerve are also seen.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 1992

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bertrand, R. A., Molina, P., Hardy, J. (1977) Vestibular syndrome and vascular anomaly in the cerebello-pontine angle. Ada Otolaryngologica, 83: 187194.CrossRefGoogle ScholarPubMed
Jannetta, P. J. (1977) Observation on the etiology of trigeminal neuralgia, hemifacial spasm, acoustic nerve dysfunction and glossopharyngeal neuralgia. Definitive microsurgical treatment and results in 117 patients. Neurochirurgia, 20: 145154.Google ScholarPubMed
Jannetta, P. J. (1980) Neurovascular compression in cranial nerve and systemic disease. Annals of Surgery, 192: 518525.CrossRefGoogle ScholarPubMed
Leclercq, T. A., Hill, C. L., Grisoli, F. (1980) Retromastoid microsurgical approach to vascular compression of the eighth cranial nerve. Laryngoscope, 90: 10111017.CrossRefGoogle ScholarPubMed
McCabe, B. R, Harker, L. A. (1983) Vascular loop as a cause of vertigo. Annals of Otology, Rhinology and Laryngology, 92: 542543.Google Scholar
McCabe, B. E., Gantz, B. J. (1989) Vascular loop as a cause of incapacitating dizziness. Equilibrium Research, 48: 211216.CrossRefGoogle Scholar
Nozue, M., Ryu, H., Uemura, K. (1987) Causes of vertigo, tinnitus and sensorineural hearing loss, especially in relation to neurovascular compression. In: The vestibular system: Neurophysiologic and clinical research. (Graham, M. D., Kemink, J. L., eds.) Raven Press, New York, p. 205209.Google Scholar
Wigand, M. E., Haid, T., Berg, M., Rettinger, G. (1983) Microchirurgische neurolyse des VIII. Hirnnerven bei cochleo-vestibularen storungen uber einen erweiterten, transtemporale zugang. HNO, 31: 295302.Google Scholar
Yeh, H. S., Tew, J. M, Ramirez, R. M. (1981) Microsurgical treatment of intractable hemifacial spasm. Neurosurgery, 9: 383386.CrossRefGoogle ScholarPubMed