Chronic emesis due to compression of the area postrema by the posterior inferior cerebellar artery: resolution following microvascular decompression

2010 ◽  
Vol 6 (6) ◽  
pp. 583-585 ◽  
Author(s):  
Martin M. Mortazavi ◽  
R. Shane Tubbs ◽  
Daniel Harmon ◽  
W. Jerry Oakes
Keyword(s):  
Microvascular Decompression ◽  
Area Postrema ◽  
Posterior Inferior Cerebellar Artery ◽  
Posterior Cranial Fossa ◽  
Significant Weight Loss ◽  
Surgical Exploration ◽  
Cerebellar Artery ◽  
Cranial Fossa ◽  
Jejunostomy Feeding

Chronic emesis may result from a variety of causes. To the authors' knowledge, compression of the area postrema by regional vessels resulting in chronic emesis has not been reported. The authors report on a child who presented with chronic medically intractable emesis and significant weight loss requiring jejunostomy feeding. Surgical exploration of the posterior cranial fossa found unilateral compression of the area postrema by the posterior inferior cerebellar artery. Microvascular decompression resulted in postoperative and long-term resolution of the patient's emesis. Although apparently very rare, irritation of the area postrema from the posterior inferior cerebellar artery with resultant medically intractable chronic emesis may occur. Therefore, the clinician should be aware of this potential etiology when dealing with such patients.

Long-term Outcomes of Microvascular Decompression in the Treatment of Hemifacial Spasm Based on Different Offending Vessels

2019 ◽  
Vol 80 (04) ◽  
pp. 285-290 ◽  
Author(s):  
Hua Zhao ◽  
Yinda Tang ◽  
Xin Zhang ◽  
Jin Zhu ◽  
Yan Yuan ◽  
...  
Keyword(s):  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
Posterior Inferior Cerebellar Artery ◽  
Study Groups ◽  
Effective Rate ◽  
Anterior Inferior Cerebellar Artery ◽  
Long Term Outcomes ◽  
Root Exit Zone ◽  
Cerebellar Artery

Objective To evaluate clinical features, outcomes, and complications in patients with hemifacial spasm (HFS) after microvascular decompression (MVD) of different offending vessels. Methods Clinical data were collected from 362 patients with HFS treated with MVD between January 2013 and January 2014. Patients were divided into five groups based on the offending vessel: A (anterior inferior cerebellar artery [AICA] compression), B (posterior inferior cerebellar artery [PICA] compression), C (AICA plus PICA compression), D (vertebral artery [VA] compression), and E (VA plus small vessel compression). Results The most common offending vessel was the AICA (51.38%). The most common compression site was the root exit zone. During the follow-up period, the effective rate was 95.48% in group A, 92.15% in group B, 93.10% in group C, 90.14% in group D, and 91.45% in group E. Twenty-nine patients exhibited delayed facial palsy, the most common complication. Conclusion No statistically significant differences were found in long-term outcomes or MVD-related complications among the study groups. The type of offending vessel was not a prognostic factor for MVD in patients with HFS.

Flat-shaped posterior cranial fossa was associated with poor outcomes of microvascular decompression for primary hemifacial spasm

2020 ◽  
Vol 162 (11) ◽  
pp. 2801-2809
Author(s):  
Kai Zhao ◽  
Junwen Wang ◽  
Weihua Liu ◽  
Jiaxuan Zhang ◽  
Kai Shu ◽  
...  
Keyword(s):  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
Posterior Cranial Fossa ◽  
Cranial Fossa ◽  
Poor Outcomes

Microvascular decompression for hemifacial spasm

1991 ◽  
Vol 75 (3) ◽  
pp. 388-392 ◽  
Author(s):  
Shinji Nagahiro ◽  
Akira Takada ◽  
Yasuhiko Matsukado ◽  
Yukitaka Ushio
Keyword(s):  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
Posterior Inferior Cerebellar Artery ◽  
Cranial Nerves ◽  
Anterior Inferior Cerebellar Artery ◽  
Vascular Compression ◽  
Content Type ◽  
Seventh Cranial Nerve ◽  
Cerebellar Artery

✓ To determine the causative factors of unsuccessful microvascular decompression for hemifacial spasm, the follow-up results in 53 patients were assessed retrospectively. The mean follow-up period was 36 months. There were 32 patients who had compression of the seventh cranial nerve ventrocaudally by an anterior inferior cerebellar artery (AICA) or a posterior inferior cerebellar artery. Of these 32 patients, 30 (94%) had excellent postoperative results. Of 14 patients with more severe compression by the vertebral artery, nine (64%) had excellent results, three (21%) had good results, and two (14%) had poor results; in this group, three patients with excellent results experienced transient spasm recurrence. There were seven patients in whom the meatal branch of the AICA coursed between the seventh and eighth cranial nerves and compressed the dorsal aspect of the seventh nerve; this was usually associated with another artery compressing the ventral aspect of the nerve (“sandwich-type” compression). Of these seven patients, five (71%) had poor results including operative failure in one and recurrence of spasm in four. The authors conclude that the clinical outcome was closely related to the patterns of vascular compression.

Microsurgical Treatment of Glossopharyngeal Neuralgia: Case Reports

Neurosurgery ◽  
1989 ◽  
Vol 25 (4) ◽  
pp. 630-632 ◽  
Author(s):  
Bernardo Fraioli ◽  
Vincenzo Esposito ◽  
Luigi Ferrante ◽  
Lanfranco Trubiani ◽  
Pierpaolo Lunardi
Keyword(s):  
Vagus Nerve ◽  
Cranial Nerve ◽  
Open Surgery ◽  
Case Reports ◽  
Cranial Nerves ◽  
Posterior Cranial Fossa ◽  
Glossopharyngeal Neuralgia ◽  
Neurovascular Compression ◽  
Cerebellar Artery ◽  
Cranial Fossa

Abstract Three patients with excruciating glossopharyngeal neuralgia underwent microsurgical operations in the posterior cranial fossa. In each patient, neurovascular compression was found involving the posteroinferior cerebellar artery and involving the 9th and 10th cranial nerves. In two of the patients, the compression was caused by arachnoiditis and in the other by an arterial loop. In each patient, neuralgia was successfully eliminated by microvascular decompression and by section of the upper rootlets of the vagus nerve. In one patient, partial section of the 9th cranial nerve was also performed. Because of the frequent involvement of the vagus nerve in the pathogenesis of this condition, open surgery should be preferable to percutaneous thermorhizotomy, which is unable to act selectively on the 10th cranial nerve.

Flat Posterior Cranial Fossa Affects Outcomes of Microvascular Decompression for Trigeminal Neuralgia

2018 ◽  
Vol 111 ◽  
pp. e519-e526 ◽  
Author(s):  
Toshiki Fukuoka ◽  
Yusuke Nishimura ◽  
Masahito Hara ◽  
Kei Nomura ◽  
Hiroshi Ryu ◽  
...  
Keyword(s):  
Trigeminal Neuralgia ◽  
Microvascular Decompression ◽  
Posterior Cranial Fossa ◽  
Cranial Fossa

scholarly journals Re-Growth of a Posterior Inferior Cerebellar Artery Aneurysm after Resection of the Associated Posterior Fossa Arteriovenous Malformation

2014 ◽  
Vol 20 (1) ◽  
pp. 61-66 ◽  
Author(s):  
Hosam Al-Jehani ◽  
Donatella Tampieri ◽  
Maria Cortes ◽  
Denis Melançon
Keyword(s):  
Arteriovenous Malformation ◽  
Posterior Fossa ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Aneurysm ◽  
Endovascular Coiling ◽  
Cerebellar Artery ◽  
Long Term Follow Up ◽  
Glue Embolization

Arteriovenous malformation (AVM)-related aneurysms have been described in the literature. Their behavior varies based on their location in relation to and the activity of the shunting through the index AVM. The intuitive expectation supported by numerous reports is that these aneurysms should regress if the AVM is excluded from the circulation. We describe a case of 46-year-old man who presented with a posterior fossa AVM with an aneurysm on the posterior inferior cerebellar artery feeding the AVM. The nidus of the AVM was successfully excluded by glue embolization, with initial regression of the PICA aneurysm on serial imaging. Five years after the endovascular treatment, the aneurysm showed significant re-growth necessitating endovascular coiling. This case presents the re-growth of an AVM-related aneurysm and emphasizes the importance of long-term follow-up of such aneurysms even if the AVM is completely excluded.

scholarly journals Microvascular decompression of the posterior inferior cerebellar artery for intermediate nerve neuralgia

2015 ◽  
Vol 6 (1) ◽  
pp. 52 ◽  
Author(s):  
IuriSantana Neville ◽  
HumbertoKluge Schroeder ◽  
DanielCiampi de Andrade ◽  
GuilhermeAlves Lepski ◽  
ManoelJacobsen Teixeira ◽  
...  
Keyword(s):  
Microvascular Decompression ◽  
Posterior Inferior Cerebellar Artery ◽  
Cerebellar Artery
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