Esqueda-Liquidano M, Georgoulis G, Brinzeu A, Sindou M, Ariñez–Barahona E, Arellano–Cervantes R, Flores–Alvarez E

Language: Spanish
References: 15
Page: 9-19
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ABSTRACT

Introduction. Disabling positional vertigo, likely to be originated by vestibular nerve (VN) vascular compression, may benefit from microvascular decompression (MVD) of VN. Most VN compressions were observed at Root Entry / Exit Zone (REZ) and adjacent brainstem or in cerebellopontine cistern. Only a few cases have been reported, conflict being within the internal auditory canal (IAC), but without detailed technical description. Authors hereby report a case with technical description.
Case report. The patient consulted for disabling vertigo. Magnetic resonance imaging did not show any vascular compression at REZ or in cerebellopontine cistern, but a loop of anterior inferior cerebellar artery (AICA) in IAC. Technical description is detailed and illustrated. After surgery vertigo attacks disappeared. The outcome was good.
Conclusion. Vestibular nerve decompression from an intrameatal loop of AICA may be the solution for disabling positional vertigo due to intrameatal neurovascular conflict evidenced by high-resolution imaging.

REFERENCES

1. Brackmann DE, Kesser BW, Day JD: Microvascular decompression of the vestibulocochlear nerve for disabling positional vertigo: the House Ear Clinic experience. Otol Neurotol 2001; 22:882–887.

2. De Ridder D, Møller A, Verlooy J, Cornelissen M, De Ridder L: Is the root entry/exit zone important in microvascular compression syndromes?. Neurosurgery 2002; 51(2): 427–433.

3. Gharabaghi A, Samii A, Koerbel A, Rosahl SK, Tatagiba M, Samii M: Preservation of function in vestibular schwannoma surgery. Neurosurgery 2007; 60 (2, Suppl 1): ONS124–ONS127.

4. Guclu B, Sindou M, Meyronet D, Streichenberger N, Simon E, Mertens P: Cranial nerve vascular compression syndromes of the trigeminal, facial, vago-glossopharyngeal nerves: comparative anatomical study of the central myeli portion and transitional zone; correlations with incidences of corresponding hyperactive dysfunctional syndromes. Acta Neurochir 2011; 153: 2365-2375.

5. Guclu B, Sindou M, Meyronet D, Streichenberger N, Simon E, Mertens P: Anatomical study of the central myelin portion and transitional zone of the vestibulocochlear nerve. Acta Neurochir 2012; 154: 2277-2283.

6. Jannetta PJ, Moller MB, Moller AR: Disabling positional vertigo. N Engl J Med 1984; 310:1700- 1705.

7. Leal PR, Hermier M, Froment JC, Souza MA, Cristino-Filho G, Sindou M: Preoperative demonstration of the neurovascular compression characteristics with special emphasis on the degree of compression, using high-resolution magnetic resonance imaging: a prospective study, with comparison to surgical findings, in 100 consecutive patients who underwent microvascular decompression for trigeminal neuralgia. Acta Neurochir 2010; 152:817–825.

8. Martin RG, Grant JL, Peace D, Theiss C, Rhoton AL. Microsurgical relationships of the anterior inferior cerebellar artery and the facial-vestibulocochlear nerve complex. Neurosurgery 1980; 6(5):483–507.

9. Mazzoni, A: Internal auditory canal: Arterial relations at the porus acusticus. Ann Otol Rhinol Laryngol 1969; 78: 797-814.

10. McCabe BF, Harker LA: Vascular loop as a cause of vertigo. Ann Otol Rhinol Laryngol 1983; 92:542– 543.

11. Møller MB, Møller AR, Jannetta PJ, Jho HD, Sekhar LN: Microvascular decompression of the eighth cranial nerve in patients with disabling positional vertigo: selection criteria and operative results in 207 patients. Acta Neurochir 1993; 125:75–82.

12. Ryu H, Yamamoto S,Sugiyama K, Nozue M: Neurovascular compression syndrome of the eight cranial nerve. What are the most reliable diagnostig signs?. Acta Neurochir 1998; 140:1279-1286.

13. Ryu H, Yamamoto S, Sugiyama K, Nishizawa S, Nozue M: Neurovascular compression syndrome of the eighth cranial nerve. Can the site of compression explain the symptoms?. Acta Neurochir 1999; 141(5):495–501.

14. Sindou M, Keravel Y: Neurochirurgie fonctionnelle dans les syndromes d’hyperactivité des nerfs crâniens: conclusions. Neurochirurgie 2009; 55: 291–292.

15. Wuertenberger CJ, Rosahl SK: Vertigo and Tinnitus Caused by Vascular Compression of the Vestibulocochlear Nerve, Not Intracanalicular Vestibular Schwannoma: Review and Case Presentation. Skull Base 2009, 19:417–424.