FFF Utilizing an Arteriovenous Vascular Loop of Two Peroneal Venae Comitantes for a PAM

Abstract BACKGROUND AND IMPORTANCE Geniculate neuralgia is a rare condition characterized by excruciating ear pain. Surgical options for geniculate neuralgia include microvascular decompression and sectioning of the nervus intermedius. We report herein a case of bilateral geniculate neuralgia treated by nervus intermedius sectioning without prior microvascular decompression. To our knowledge, this is the first report of this treatment strategy with a subsequent description of the side effects of bilateral nervus intermedius disruption. CLINICAL PRESENTATION A 54-yr-old woman presented with bilateral geniculate neuralgia, worse on the left, refractory to medical therapy. Surgical treatment options were reviewed, including microvascular decompression and sectioning of the nervus intermedius. She opted for left nervus intermedius sectioning. The procedure was uncomplicated and no compressive vascular loop was identified during surgery. Postoperatively, she had complete symptom resolution with no discernable side effects. Three years later, the patient developed worsening geniculate neuralgia on the contralateral side. After the discussion of treatment options, she opted again for sectioning of the contralateral nervus intermedius with successful resolution of all symptoms after surgery. Following surgery, the patient identified partial impairment of lacrimation and gustation. She continued to have functional taste of the anterior two-thirds of the tongue, lacrimation, and hearing bilaterally. CONCLUSION Bilateral sectioning of nervus intermedius may provide benefit in patients with bilateral geniculate neuralgia without egregious side effects. However, lacrimatory and gustatory alterations are a potentially significant side effect with a wide range of symptomatology.

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Prepapillary Vascular Loop

Clinico-Pathological Atlas of Congenital Fundus Disorders ◽

10.1007/978-1-4613-9320-7_31 ◽

1993 ◽

pp. 143-144

Author(s):

Juan Orellana ◽

Alan H. Friedman

Keyword(s):

Vascular Loop

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The Analysis of the Relationship Between Subjective Tinnitus and Vascular Loop, and Age and Gender Distribution: An MRI Study

Eurasian Journal of Medicine and Oncology ◽

10.14744/ejmo.2018.0038 ◽

2018 ◽

Author(s):

Esen Derin Cicek

Keyword(s):

Age And Gender ◽

Gender Distribution ◽

Subjective Tinnitus ◽

And Gender ◽

Mri Study ◽

The Relationship ◽

Vascular Loop

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Evaluation of the Relationship Between the Internal Acoustic Canal Anatomy and Loops of the Anterior Inferior Cerebellar Artery Using 3-Tesla Magnetic Resonance Imaging

Iranian Journal of Radiology ◽

10.5812/iranjradiol.112305 ◽

2021 ◽

Vol 18 (4) ◽

Author(s):

Murat Bayav ◽

Murat Sahin

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Anatomical Variations ◽

3 Tesla ◽

Anterior Inferior Cerebellar Artery ◽

Resonance Imaging ◽

Cerebellar Artery ◽

The Relationship ◽

Internal Acoustic Canal ◽

Vascular Loop

Background: Anatomical variations in vascular structures are frequently encountered. In the cerebellopontine region, anatomical variations, especially variations in the anterior inferior cerebellar artery (AICA) in relation to cranial nerves passing through the internal acoustic canal (IAC), are common. Magnetic resonance imaging (MRI) provides detailed information for the evaluation of the cerebellopontine region and the IAC anatomy. Objectives: This study aimed to examine the relationship between the IAC anatomy and AICA loop variations and to investigate the frequency of anatomical variations and its correlation with demographic variables. Patients and Methods: In this study, 253 patients (age > 18 years), who underwent 3-Tesla MRI of the temporal bone between July 2019 and December 2019, were retrospectively evaluated. The exclusion criteria were images of poor diagnostic quality due to technical or patient-related reasons and the presence of a localized tumor that could disrupt the IAC. Four patients were excluded from the study because they had tumors related to IAC. The AICA variations were categorized according to the Chavda classification. The IAC size, canal diameter, canal length, and meatus width were measured, and the canals were characterized as cylindrical, funnel-shaped, and bud-shaped. Results: A total of 249 patients were included in this study. The Chavda type I vascular loop was the most common type on both sides. The mean size measurements of IACs were significantly higher in the group of vascular loops compared to the group without vascular loops. The presence of a vascular loop was significantly more common in funnel- and bud-shaped IACs compared to cylindrical IAC. Also, there was a negative correlation between the patient’s age and all IAC dimensions. Conclusion: The results of the present study showed that the AICA loop variations were closely related to the size and shape of the IAC.

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