scholarly journals Strategical implications of aneurysmal cranial nerve compression

2012 ◽  
Vol 58 (2-3) ◽  
pp. 146-150 ◽  
Author(s):  
F. Scholtes ◽  
D. Martin
Keyword(s):  
Cranial Nerve ◽  
Nerve Compression

scholarly journals Delayed Pneumocephalus-Induced Cranial Neuropathy

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Neena I. Marupudi ◽  
Monika Mittal ◽  
Sandeep Mittal
Keyword(s):  
Cranial Nerve ◽  
Nerve Palsy ◽  
Oculomotor Nerve ◽  
Nerve Compression ◽  
Neurological Deficits ◽  
Oculomotor Nerve Palsy ◽  
Cranial Neuropathy ◽  
Cranial Nerve Deficit ◽  
Moderate Amount ◽  
Interpeduncular Cistern

Pneumocephalus is a common occurrence after cranial surgery, with patients typically remaining asymptomatic from a moderate amount of intracranial air. Postsurgical pneumocephalus rarely causes focal neurological deficits; furthermore, cranial neuropathy from postsurgical pneumocephalus is exceedingly uncommon. Only 3 cases have been previously reported that describe direct cranial nerve compression from intracranial air resulting in an isolated single cranial nerve deficit. The authors present a patient who developed dysconjugate eye movements from bilateral oculomotor nerve palsy. Direct cranial nerve compression occurred as a result of postoperative pneumocephalus in the interpeduncular cistern. The isolated cranial neuropathy gradually recovered as the intracranial air was reabsorbed.

scholarly journals Cranial polyneuropathy caused by vertebrobasilar

2020 ◽  
Vol 2 (1) ◽  
pp. 1-4 ◽  
Author(s):  
Tay Poh Sen ◽  
Noor Aida Mat Daud ◽  
Hilwati Hashim
Keyword(s):  
Trigeminal Neuralgia ◽  
Cranial Nerve ◽  
Nerve Palsy ◽  
Hypoglossal Nerve ◽  
Nerve Compression ◽  
Hypoglossal Nerve Palsy ◽  
Vertebrobasilar System ◽  
Vertebrobasilar Dolichoectasia

Vertebrobasilar Dolichoectasia (VBD) is a condition characterized by abnormal elongation, dilatation and tortuosity of the vertebrobasilar system. It is usually asymptomatic but rarely, it can present with cranial nerve compression symptoms. We present a case of simultaneous trigeminal neuralgia and hypoglossal nerve palsy due to compression by VBD. Neuroimaging plays an important role in diagnosing this condition so that further treatment can be provided.

Bone Cement Cranioplasty Reduces Cerebrospinal Fluid Leak Rate after Microvascular Decompression: A Single-Institutional Experience

2020 ◽  
Author(s):  
Daniel I. Wolfson ◽  
Jordan A. Magarik ◽  
Saniya S. Godil ◽  
Hamid M. Shah ◽  
Joseph S. Neimat ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Logistic Regression ◽  
Regression Model ◽  
Bone Cement ◽  
Microvascular Decompression ◽  
Cranial Nerve ◽  
Logistic Regression Model ◽  
Nerve Compression ◽  
Leak Rate ◽  
Csf Leak

Abstract Background Microvascular decompression (MVD) is a common surgical treatment for cranial nerve compression, though cerebrospinal fluid (CSF) leak is a known complication of this procedure. Bone cement cranioplasty may reduce rates of CSF leak. Objective To compare rates of CSF leak before and after implementation of bone cement cranioplasty for the reconstruction of cranial defects after MVD. Methods Retrospective chart review was performed of patients who underwent MVD through retrosigmoid craniectomy for cranial nerve compression at a single institution from 1998 to 2017. Study variables included patient demographics, medical history, type of closure, and postoperative complications such as CSF leak, meningitis, lumbar drain placement, and ventriculoperitoneal shunt insertion. Cement and noncement closure groups were compared, and predictors of CSF leak were assessed using a multivariate logistic regression model. Results A total of 547 patients treated by 10 neurosurgeons were followed up for more than 20 years, of whom 288 (52.7%) received cement cranioplasty and 259 (47.3%) did not. Baseline comorbidities were not significantly different between groups. CSF leak rate was significantly lower in the cement group than in the noncement group (4.5 vs. 14.3%; p < 0.001). This was associated with significantly fewer patients developing postoperative meningitis (0.7 vs. 5.2%; p = 0.003). Multiple logistic regression model demonstrated noncement closure as the only independent predictor of CSF leak (odds ratio: 3.55; 95% CI: 1.78–7.06; p < 0.001). Conclusion CSF leak is a well-known complication after MVD. Bone cement cranioplasty significantly reduces the incidence of postoperative CSF leak and other complications. Modifiable risk factors such as body mass index were not associated with the development of CSF leak.

Macrovascular Decompression of Facial Nerve With Anteromedial Transposition of a Dolichoectatic Vertebral Artery: 3-Dimensional Operative Video

2018 ◽  
Vol 16 (1) ◽  
pp. E4-E4
Author(s):  
Halima Tabani ◽  
Sonia Yousef ◽  
Jan-Karl Burkhardt ◽  
Sirin Gandhi ◽  
Arnau Benet ◽  
...  
Keyword(s):  
Trigeminal Neuralgia ◽  
Facial Nerve ◽  
Hemifacial Spasm ◽  
Cranial Nerve ◽  
Nerve Compression ◽  
Large Artery ◽  
Nerve Compression Syndromes ◽  
Vertebrobasilar Artery ◽  
Patient Consent ◽  
Compression Syndromes

Abstract Most cranial nerve compression syndromes (ie, trigeminal neuralgia and hemifacial spasm) are caused by small arteries impinging on a nerve and are relieved by microvascular decompression. Rarely, cranial nerve compression syndromes can be caused by large artery impingement and can be relieved by macrovascular decompression. When present, this compression often occurs in association with degenerative atherosclerosis in the vertebral arteries (VA) and basilar artery. Conservative treatment is recommended for mild forms, but surgical transposition of the VA away from the root entry zone (REZ) can be considered. This video demonstrates macrovascular decompression of a dolichoectatic VA in a 74-yr-old female with refractory left hemifacial spasm. After obtaining IRB approval, patient consent was sought for the procedure. With the patient in three-quarter-prone position, a far-lateral craniotomy was performed. The dentate ligament was cut to free the VA, and the suprahypoglossal portion of the vagoaccessory triangle was widened. VA compressed the REZ of the facial nerve, but was mobilized anteromedially off the REZ. A muslin sling was wrapped around the VA and its tail brought down to the clival dura, which was punctured with a 19-gauge needle and enlarged with a dissector. The sling was pulled anteromedially to this puncture site and secured to the dura with an aneurysm clip, relieving the REZ of all compression. The patient tolerated the procedure with mild, transient hoarseness and her hemifacial spasm resolved completely. This case demonstrates the macrovascular decompression technique with anteromedial transposition of the vertebrobasilar artery, which can also be used for trigeminal neuralgia.

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