scholarly journals Vestibulocochlear Symptoms Caused by Vertebrobasilar Dolichoectasia

2020 ◽  
Vol 13 (2) ◽  
pp. 123-132 ◽  
Author(s):  
Gene Huh ◽  
Yun Jung Bae ◽  
Hyun Jun Woo ◽  
Jung Hyun Park ◽  
Ja-Won Koo ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Cranial Nerve ◽  
Internal Auditory Canal ◽  
Case Series ◽  
Vestibular Function ◽  
Neurovascular Compression ◽  
Vestibulocochlear Nerve ◽  
Radiologic Evaluation ◽  
Vertebrobasilar Dolichoectasia ◽  
Vertebrobasilar Artery

Objectives. Vertebrobasilar dolichoectasia (VBD), an elongation and distension of vertebrobasilar artery, may present with cranial nerve symptoms due to nerve root compression. The objectives of this study are to summarize vestibulocochlear manifestations in subjects with VBD through a case series and to discuss the needs of thorough oto-neurotologic evaluation in VBD subjects before selecting treatment modalities.Methods. Four VBD subjects with vestibulocochlear manifestations were reviewed retrospectively. VBD was confirmed by either brain or internal auditory canal magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA). Patient information, medical history, MRI/MRA findings, and audiometry or vestibular function tests were reviewed according to patient’s specific symptom.Results. Of the four subjects, three presented with ipsilesional sensorineural hearing loss (SNHL), three with paroxysmal recurrent vertigo, and two with typewriter tinnitus. The MRI/MRA of the four subjects revealed unilateral VBD with neurovascular compression of cisternal segment or the brainstem causing displacement, angulation, or deformity of the cranial nerve VII or VIII that corresponded to the symptoms.Conclusion. Vestibulocochlear symptoms such as SNHL, recurrent paroxysmal vertigo, or typewriter tinnitus can be precipitated from a neurovascular compression of the vestibulocochlear nerve by VBD. Because proper medical or surgical treatments may stop the disease progression or improve audio-vestibular symptoms in subjects with VBD, a high index of suspicion and meticulous radiologic evaluation are needed when vestibulocochlear symptoms are not otherwise explainable, and if VBD is confirmed to cause audiovestibular manifestation, a thorough oto-neurotologic evaluation should be performed before initial treatment.

scholarly journals Magnetic resonance imaging findings of isolated abducent nerve palsy induced by vascular compression of vertebrobasilar dolichoectasia

2017 ◽  
Vol 08 (01) ◽  
pp. 124-127 ◽  
Author(s):  
Hidetaka Arishima ◽  
Ken-ichiro Kikuta
Keyword(s):  
Magnetic Resonance ◽  
General Condition ◽  
Nerve Palsy ◽  
Laboratory Data ◽  
Vascular Compression ◽  
Neurovascular Compression ◽  
Vertebrobasilar Dolichoectasia ◽  
Vertebrobasilar Artery ◽  
Abducent Nerve Palsy ◽  
Abducent Nerve

ABSTRACTIf the origin of isolated abducent nerve palsy cannot be found on neuroradiological examinations, diabetes mellitus is known as a probable cause; however, some cases show no potential causes of isolated abducent nerve palsy. Here, we report a 74-year-old male who suffered from diplopia due to isolated left abducent nerve palsy. Magnetic resonance angiography and fast imaging employing steady-state acquisition imaging clearly showed a dolichoectasic vertebrobasilar artery compressing the left abducent nerve upward and outward. There were no abnormal lesions in the brain stem, cavernous sinus, or orbital cavity. Laboratory data showed no abnormal findings. We concluded that neurovascular compression of the left abducent nerve might cause isolated left abducent nerve palsy. We observed him without surgical treatment considering his general condition with angina pectoris and old age. His symptom due to the left abducent nerve palsy persisted. From previous reports, conservative treatment could not improve abducent nerve palsy. Microvascular decompression should be considered for abducent nerve palsy due to vascular compression if patients are young, and their general condition is good. We also discuss interesting characteristics with a review of the literature.

scholarly journals Decompression of the internal auditory canal via the retrosigmoid approach in a patient with Camurati-Engelmann disease: illustrative case

2021 ◽  
Vol 1 (4) ◽  
Author(s):  
Salah-Eddine Achahbar ◽  
Thomas Somers ◽  
Tony Van Havenbergh
Keyword(s):  
Facial Nerve ◽  
Skull Base ◽  
Internal Auditory Canal ◽  
Vestibular Function ◽  
Retrosigmoid Approach ◽  
Foraminal Stenosis ◽  
Illustrative Case ◽  
Vestibulocochlear Nerve ◽  
Cranial Neuropathies ◽  
Engelmann Disease

BACKGROUNDCamurati-Engelmann disease (CED) is a rare condition characterized by hyperostosis of the long bones and skull base. Symptoms include contractures and pain in affected extremities but can also include manifestations of cranial hyperostosis such as intracranial hypertension, Chiari malformation, exophthalmia, frontal bossing, and several cranial neuropathies due to cranial foraminal stenosis.OBSERVATIONSThis report describes a 27-year-old patient with suspected CED who developed progressive intermittent facial nerve paresis, hemifacial spasms, and a decrease in hearing. There were no symptoms of increased intracranial pressure or vertigo. Radiological evaluation showed a significant thickening of the skull base with serious bilateral internal auditory canal stenosis. Because of the progressive nature of the aforementioned cranial neuropathies in combination with the correlating severe radiological compression, a surgical decompression of the facial nerve and vestibulocochlear nerve was performed via a retrosigmoid approach with intraoperative monitoring. Postoperative facial nerve function was intact. Hearing and vestibular function were unchanged. There were no more episodes of facial nerve palsy or spasm.LESSONSTo the authors’ knowledge, this is the first report to describe decompression of the internal auditory canal via a retrosigmoid approach for symptomatic facial and cochlear nerve compression in a patient with CED.

Narrow internal auditory canal syndrome: parasaggital reconstruction

2000 ◽  
Vol 114 (5) ◽  
pp. 392-394 ◽  
Author(s):  
Yang-Sun Cho ◽  
Dong Gyu Na ◽  
Jae Yun Jung ◽  
Sung Hwa Hong
Keyword(s):  
Magnetic Resonance ◽  
High Resolution ◽  
Facial Nerve ◽  
Temporal Bone ◽  
Magnetic Resonance Image ◽  
Internal Auditory Canal ◽  
The Other ◽  
Vestibulocochlear Nerve ◽  
Computed Tomographic ◽  
Canal Syndrome

Narrow internal auditory canal (IAC) syndrome is a malformation of the temporal bone, that is defined as an IAC diameter of only 1–2 mm on high-resolution computed tomographic scans (HRCT). This syndrome is known to be caused by the absence (aplasia or hypoplasia) of the vestibulocochlear nerve. We present a case of unilateral narrow IAC syndrome which was diagnosed by HRCT. The aplasia of the vestibulocochlear nerve was confirmed using parasigittal reconstruction magnetic resonance image (MRI). The IAC was composed of two separate canals, one of which contained a facial nerve and the other was empty with aplasia of the vestibulocochlear nerve.

Cranial nerve vascular compression syndromes

2019 ◽  
pp. 909-928
Author(s):  
Marc Sindou ◽  
George Georgoulis
Keyword(s):  
High Resolution ◽  
Trigeminal Neuralgia ◽  
Cranial Nerve ◽  
Clinical Manifestations ◽  
Ventrolateral Medulla ◽  
Vascular Compression ◽  
Neurovascular Compression ◽  
Mri Imaging ◽  
Neurovascular Conflict ◽  
Vestibulocochlear Nerve

Hyperactive cranial nerve syndromes originate in a large number of cases from chronic neurovascular conflict. Classical trigeminal neuralgia is the most frequent syndrome, followed by primary hemifacial spasm. Vago-glossopharyngeal neuralgia is rare, but still underestimated. Vascular compression of the vestibulocochlear nerve may be at the origin of tinnitus and positional disabling vertigo. Vascular compression of the ventrolateral medulla can be a possible cause of neurogenic essential blood hypertension. Chronic pulsatile neurovascular compression would generate ectopic stimuli that are transmitted to neighbouring fibres through focal zones of demyelination, which provokes an ephaptic mechanism between fibres. Also, chronic pulsatile compression would induce hyperactivity of the corresponding cranial nerve nuclei. In trigeminal neuralgia this hyperactivity is expressed by epileptic-like clinical manifestations that respond to anticonvulsants. MRI imaging with high-resolution protocol, and the three following sequences—3D T2 high-resolution, TOF MR-angiography, and T1 with gadolinium—permit to depict the neurovascular conflict and predict the degree of compression. First option of the treatment is microvascular decompression.

Duplicate internal auditory canals with facial and vestibulocochlear nerve dysfunction

2011 ◽  
Vol 126 (1) ◽  
pp. 66-71 ◽  
Author(s):  
T Y Kew ◽  
A Abdullah
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Facial Nerve ◽  
Clinical Presentation ◽  
Facial Nerve Palsy ◽  
Internal Auditory Canal ◽  
Resonance Imaging ◽  
Radiological Findings ◽  
Vestibulocochlear Nerve ◽  
Nerve Dysfunction

AbstractObjective:We report an extremely rare case of duplication of the internal auditory canal associated with dysfunction of both the facial and vestibulocochlear nerves. We also review the literature regarding the integrity of the facial and vestibulocochlear nerves in such cases.Case report:A 34-year-old man presented with unilateral, right-sided, sensorineural hearing loss and facial nerve palsy since childhood. Facial nerve function was observed to be House–Brackmann grade III. Computed tomography and magnetic resonance imaging demonstrated ipsilateral duplicate, vacant internal auditory canals. Based on the clinical presentation, we interpreted these radiological findings as aplasia of the vestibulocochlear nerve and severe hypoplasia of the facial nerve.Conclusion:To our best knowledge, this is the first report of vestibulocochlear nerve aplasia and severe facial nerve hypoplasia in a case of ipsilateral duplication of the internal auditory canal. High resolution gradient echo magnetic resonance imaging sequences are advocated for assessment of neural integrity in patients with an abnormal internal auditory canal and facial and/or vestibulocochlear nerve dysfunction.

Fascicular torsions of the anterior and posterior interosseous nerve in 4 cases: neuroimaging methods to improve diagnosis

2020 ◽  
Vol 132 (6) ◽  
pp. 1925-1929 ◽  
Author(s):  
Jennifer Kollmer ◽  
Paul Preisser ◽  
Martin Bendszus ◽  
Henrich Kele
Keyword(s):  
Magnetic Resonance ◽  
Surgical Intervention ◽  
Case Series ◽  
Diagnostic Methods ◽  
Posterior Interosseous Nerve ◽  
Nerve Ultrasound ◽  
Magnetic Resonance Neurography ◽  
Surgical Exploration ◽  
Hyperintense Signal ◽  
Emergency Surgical Intervention

Diagnosis of spontaneous fascicular nerve torsions is difficult and often delayed until surgical exploration is performed. This case series raises awareness of peripheral nerve torsions and will facilitate an earlier diagnosis by using nerve ultrasound (NUS) and magnetic resonance neurography (MRN). Four patients with previously ambiguous upper-extremity mononeuropathies underwent NUS and 3T MRN. Neuroimaging detected proximal torsions of the anterior and posterior interosseous nerve fascicles within median or radial nerve trunks in all patients. In NUS, most cases presented with a thickening of affected nerve fascicles, followed by an abrupt caliber decrease, leading to the pathognomonic sausage-like configuration. MRN showed T2-weighted hyperintense signal alterations of fascicles at and distal to the torsion site, and directly visualized the distorted nerves. Three patients had favorable outcomes after being transferred to emergency surgical intervention, while 1 patient with existing chronic muscle atrophy was no longer eligible for surgery. NUS and MRN are complementary diagnostic methods, and both can detect nerve torsions on a fascicular level. Neuroimaging is indispensable for diagnosing fascicular nerve torsions, and should be applied in all unclear cases of mononeuropathy to determine the diagnosis and if necessary, to guide surgical therapies, as only timely interventions enable favorable outcomes.

scholarly journals Pancreatico‑pleural Fistula: Case Series

2018 ◽  
Vol 09 (01) ◽  
pp. 026-031 ◽  
Author(s):  
Manoj Munirathinam ◽  
Pugazhendhi Thangavelu ◽  
Ratnakar Kini
Keyword(s):  
Magnetic Resonance ◽  
Pleural Effusion ◽  
Pleural Fluid ◽  
Case Series ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Fluid Analysis ◽  
High Index Of Suspicion ◽  
Enhanced Computed Tomography ◽  
Acute And Chronic Pancreatitis ◽  
Pancreatic Pathology

ABSTRACTPancreatico‑pleural fistula is a rare but serious complication of acute and chronic pancreatitis. The pleural effusion caused by pancreatico‑pleural fistula is usually massive and recurrent. It is predominately left‑sided but right‑sided and bilateral effusion does occur. We report four cases of pancreatico‑pleural fistula admitted to our hospital. Their clinical presentation and management aspects are discussed. Two patients were managed by pancreatic endotherapy and two patients were managed conservatively. All four patients improved symptomatically and were discharged and are on regular follow‑up. Most of these patients would be evaluated for their breathlessness and pleural effusion delaying the diagnosis of pancreatic pathology and management. Hence, earlier recognition and prompt treatment would help the patients to recover from their illnesses. Pancreatic pleural fistula diagnosis requires a high index of suspicion in patients presenting with chest symptoms or pleural effusion. Extremely high pleural fluid amylase levels are usual but not universally present. A chest X‑ray, pleural fluid analysis, and abdominal imaging (magnetic resonance cholangiopancreatography/magnetic resonance imaging abdomen more useful than contrast‑enhanced computed tomography abdomen) would clinch the diagnosis. Endoscopic retrograde cholangiopancreatography with stent or sphincterotomy should be considered when pancreatic duct (PD) reveals a stricture or when medical management fails in patients with dilated or irregular PD. Surgical intervention may be indicated in patients with complete disruption of PD or multiple strictures.

scholarly journals Magnetic resonance imaging findings in children with Parry-Romberg syndrome and en coup de sabre

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Harry Knights ◽  
Elizabeth Minas ◽  
Faraan Khan ◽  
Lindsay Shaw ◽  
Muthana Al Obaidi ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
White Matter ◽  
Magnetic Resonance ◽  
Brain Imaging ◽  
Case Series ◽  
Dystrophic Calcification ◽  
Resonance Imaging ◽  
Cutaneous Manifestations ◽  
Street Hospital ◽  
Parry Romberg Syndrome

Abstract Background The aim of this study was to: (i) describe the abnormalities seen on brain imaging in a group of children with en coup de sabre (EDCS) with/without Parry-Romberg syndrome (PRS); and (ii) identify clinical predictors of brain imaging abnormalities. Methods This was a single centre (Great Ormond Street Hospital, London) retrospective case series of patients with ECDS/PRS seen from 2000 to 2018. We identified patients with cutaneous manifestations consistent with the clinical descriptions of ECDS/PRS. Presenting clinical, laboratory, and radiological brain findings are described. Results are expressed as medians and ranges or frequencies and percentages. Fisher’s exact test was used to identify clinical associations with magnetic resonance imaging (MRI) abnormalities. Results Fourteen patients were studied: 6 males and 8 females; median age 14 years (range 3–20). We observed neuroimaging abnormalities in 2/6 ECDS and 5/8 ECDS/PRS patients. White matter signal abnormality, dystrophic calcification, leptomeningeal enhancement, and sulcal crowding were the typical findings on brain imaging. A total of 50% of patients had no MRI abnormality despite some of these patients having neurological symptoms. The presence of seizures was significantly associated with ipsilateral enhanced white matter signalling on MRI (p < 0.05). Conclusions In summary, we observed several distinct radiographic patterns associated with ECDS/PRS. Seizure disorder was strongly associated with the presence of ipsilateral enhanced white matter signalling. Improved neuroimaging techniques that combine morphological with functional imaging may improve the detection rate of brain involvement in children with ECDS/PRS in the future.

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