This is a valuable clinical study on the multiple involvement of cranial nerves in vascular compression syndromes, so-called HDSs.

AbstractVascular compression syndromes are rare alterations that have in common the compression of an arterial and/or venous vessel by contiguous structures and can be congenital or acquired. The best known are the Thoracic Outlet Syndrome, Nutcracker Syndrome, May–Thurner Syndrome, and Dunbar Syndrome. The incidence of these pathologies is certainly underestimated due to the non-specific clinical signs and their frequent asymptomaticity. Being a first-level method, Ultrasound plays a very important role in identifying these alterations, almost always allowing a complete diagnostic classification. If in expert hands, this method can significantly contribute to the reduction of false negatives, especially in the asymptomatic population, where the finding of the aforementioned pathologies often happens randomly following routine checks. In this review, we briefly discuss the best known vascular changes, the corresponding ultrasound anatomy, and typical ultrasound patterns.

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Disease of lower cranial nerves caused by vascular compression

Acta chirurgica iugoslavica ◽

10.2298/aci0802027a ◽

2008 ◽

Vol 55 (2) ◽

pp. 27-31 ◽

Cited By ~ 1

Author(s):

B.D. Antic ◽

P. Peric ◽

S.Lj. Stefanovic

Keyword(s):

Surgical Treatment ◽

Cranial Nerves ◽

Postoperative Outcome ◽

Glossopharyngeal Neuralgia ◽

Statistic Analysis ◽

Vascular Compression ◽

Excellent Outcome ◽

Surgical Options ◽

Lower Cranial Nerves ◽

Surgical Option

Between April 1989 and September 2007, 181 patients with disease of lower cranial nerves (DLCN) underwent posterior fossa exploration. As a cause of DLCN, vascular compression (VC) was present in 89 patients with trigeminal neuralgia (TN), in 6 with hemifacial spasm (HFS), in 1 with glossopharyngeal neuralgia, in 1 with Meniere?s disease, and in 5 with multiple DLCN. Depending on intraoperative findings, different surgical options were used: microvascular decompression (MVD), MVD with partial sensory rhizotomy (PSR) or total sensory rhizotomy (TSR). Statistic analysis was made using the Fisher?s exact 2-side test. In patients with TN, excellent outcome was archived in 83 patients and good in 6. Postoperative outcome was better (p = 0.007) in cases with severe VC, but without significant correlation between used surgical option and outcome (p = 0.402). Frequency rate of relapses did not depend on severity of VC (p = 0.502) and used surgical option (p = 0.175). In 6 patients with HFS, excellent outcome was archived in 5 with arterial compression and poor in 1 with venous contact. In patients with Meniere?s disease and glossopharyngeal neuralgia, MVD result with excellent outcome. In 5 patients with multiple DLCN, excellent outcome was archived in 3 and good in 2. MVD is method of choice in surgical treatment of DLCN caused by VC. Overall outcome is better with severity of VC.

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Concomitant Ectatic Posterior Communicating Artery and Tentorial Meningioma as a Source of Oculomotor Palsy: Case Report

Neurosurgery ◽

10.1227/01.neu.0000187448.96386.03 ◽

2005 ◽

Vol 57 (6) ◽

pp. E1316-E1316 ◽

Cited By ~ 4

Author(s):

Jesse D. Babbitz ◽

Griffith R. Harsh

Keyword(s):

Cranial Nerves ◽

Oculomotor Nerve ◽

Posterior Communicating Artery ◽

Vascular Compression ◽

Oculomotor Palsy ◽

Complete Evaluation ◽

Third Nerve Palsy ◽

Ocular Movements ◽

Tentorial Meningioma ◽

Third Nerve

Abstract OBJECTIVE AND IMPORTANCE: Although non-aneurysmal vascular compression of the oculomotor nerve is rare, it should be considered in the evaluation of unilateral oculomotor palsy. CLINICAL PRESENTATION: A 36-year-old non-diabetic man presented with two months of intermittent retro-orbital headache and third nerve paresis caused by compression of the oculomotor nerve between an ectatic, atherosclerotic posterior communicating artery (PComA) and a small tentorial meningioma. At operation, the subarachnoid portion of the nerve, prevented from migrating posteriorly and laterally by the meningioma, was grooved by the apex of the artery's loop. INTERVENTION: Microvascular decompression (MVD) of the artery loop from the nerve and resection of the meningioma were performed. Postoperatively, the patient's retro-orbital headache and oculomotor paresis, with the exception of mild anisocoria, resolved. Tumor infiltrating the posterior tentorium and lateral cavernous sinus was treated by Cyberknife radiosurgery five months later. One year after surgery, the patient had improvement in his headaches, full extra-ocular movements, and minimal residual anisocoria. CONCLUSION: Only one other report describes MVD of the third nerve from PComA compression. A review is presented of MVD carried out for similar cases of non-aneurysmal vascular compression of the oculomotor nerve. By analogy from cases in which an aneurysm is the compressing vascular structure, prompt surgical treatment is advocated. Complete evaluation of an isolated third nerve palsy should include MRI sequences designed to detect vascular compression of cranial nerves.

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Vascular Compression Syndromes

Encyclopedia of Pain ◽

10.1007/978-3-540-29805-2_4725 ◽

2006 ◽

pp. 2604-2604

Keyword(s):

Vascular Compression ◽

Compression Syndromes

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Vascular Compression Syndromes

Functional Surgery of Cerebellopontine Angle by Minimally Invasive Retrosigmoid Approach ◽

10.5005/jp/books/11851_6 ◽

2013 ◽

pp. 71-71

Author(s):

Jacques Magnan ◽

Bhavin Parikh ◽

Hidemi Miyazaki

Keyword(s):

Vascular Compression ◽

Compression Syndromes

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Endoscopic-Assisted Microvascular Decompression

Effective Techniques for Managing Trigeminal Neuralgia - Advances in Medical Diagnosis, Treatment, and Care ◽

10.4018/978-1-5225-5349-6.ch007 ◽

2018 ◽

pp. 139-154

Author(s):

M. Yashar S. Kalani ◽

Michael R. Levitt ◽

Celene B. Mulholland ◽

Charles Teo ◽

Peter Nakaji

Keyword(s):

Trigeminal Neuralgia ◽

Minimally Invasive ◽

Effective Treatment ◽

Hemifacial Spasm ◽

Microvascular Decompression ◽

Patient Population ◽

Surgical Intervention ◽

Cranial Nerves ◽

Vascular Compression ◽

Ephaptic Transmission

Diseases of ephaptic transmission are commonly caused by vascular compression of cranial nerves. The advent of microvascular decompression has allowed for surgical intervention for this patient population. This chapter highlights the technique of endoscopic-assisted microvascular decompression for trigeminal neuralgia and hemifacial spasm. Endoscopy and keyhole techniques have resulted in a minimally invasive and effective treatment of symptoms for patients with neuralgia.

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