scholarly journals Reappearance of Cranial Nerve Dysfunction Symptoms Caused by New Artery Compression More than 20 Years after Initially Successful Microvascular Decompression: Report of Two Cases

2016 ◽  
Vol 56 (2) ◽  
pp. 77-80 ◽  
Author(s):  
Hiroto INOUE ◽  
Akinori KONDO ◽  
Hiroshi SHIMANO ◽  
Soichiro YASUDA ◽  
Kenichi MURAO
Keyword(s):  
Microvascular Decompression ◽  
Cranial Nerve ◽  
Cranial Nerve Dysfunction ◽  
Nerve Dysfunction

Bulbar Compression by an Ectatic Vertebral Artery: A Novel Neurovascular Construct Relieved by Microsurgical Decompression

2005 ◽  
Vol 56 (suppl_1) ◽  
pp. ONS-117-ONS-124 ◽  
Author(s):  
Francesco Tomasello ◽  
Concetta Alafaci ◽  
Francesco M. Salpietro ◽  
Marcello Longo
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Vertebral Artery ◽  
Medulla Oblongata ◽  
Microvascular Decompression ◽  
Cranial Nerve ◽  
Resonance Imaging ◽  
Cranial Nerve Dysfunction ◽  
Nerve Dysfunction ◽  
The Right

Abstract OBJECTIVE: Brainstem compression caused by vascular abnormalities has rarely been reported in the literature. We describe five cases of large ectatic vertebral artery causing compression and distortion of the medulla oblongata with pyramidal tract signs and low cranial nerve dysfunction. Microvascular decompression by retracting the vertebral artery and anchoring it to the dura has been the treatment of choice. METHODS: Five patients, four male and one female, presented with progressive myelopathic features and lower cranial nerve dysfunction, especially dysphonia and dysphagia. Four patients were affected by systemic arterial hypertension. Magnetic resonance imaging showed impingement of the right vertebral artery in three patients and the left vertebral artery in two patients, on the right and left lateral medulla, respectively. In two patients, hypoplasia of the contralateral vertebral artery was documented. RESULTS: All patients underwent neurovascular decompression of the medulla oblongata. The ectatic and tortuous vertebral artery was detached from the medulla, shifted away, and repositioned by anchoring to the nearby dura mater using a Gore-Tex vascular slip. Postoperatively, all patients but one had improvement of their previous neurological symptoms. CONCLUSION: Brainstem dysfunction caused by a tortuous ectatic vertebral artery might be less uncommon than expected. It should be considered a new distinct clinical entity, the real incidence of which needs to be carefully evaluated by an appropriate diagnostic protocol, which includes primarily magnetic resonance imaging with specific three-dimensional sequences. Awareness of this condition is necessary to ensure the appropriate treatment. Surgical microvascular decompression seems very effective.

Monitoring auditory functions during cranial nerve microvascular decompression operations by direct recording from the eighth nerve

1983 ◽  
Vol 59 (3) ◽  
pp. 493-499 ◽  
Author(s):  
Aage R. Møller ◽  
Peter J. Jannetta
Keyword(s):  
Microvascular Decompression ◽  
Cranial Nerve ◽  
Auditory Evoked Potentials ◽  
Evoked Responses ◽  
Content Type ◽  
Eighth Nerve ◽  
Cranial Nerve Dysfunction ◽  
Direct Recording ◽  
Nerve Dysfunction ◽  
Auditory Functions

✓ A method is described for recording sound-evoked responses directly from the eighth nerve during operations in the cerebellopontine angle, particularly during microvascular decompression operations for cranial nerve dysfunction. This method provides important information to the surgeon during the operation that cannot be provided by recording brain-stem auditory evoked potentials (BAEP) using surface electrodes. By recording sound-evoked responses intracranially and recording BAEP with scalp electrodes, the risk of hearing loss in these operations is decreased.

Persistent triplegia and cranial nerve dysfunction after lysis of epidural adhesions

2021 ◽  
Vol 8 (4) ◽  
Author(s):  
Marco LA GRUA ◽  
Irene GRAZZINI ◽  
Gian L. CUNEO ◽  
Gianfranco SINDACO ◽  
Matteo ZANELLA ◽  
...  
Keyword(s):  
Cranial Nerve ◽  
Cranial Nerve Dysfunction ◽  
Nerve Dysfunction

scholarly journals Hemorrhagic vestibular schwannoma: an unusual clinical entity

1998 ◽  
Vol 5 (3) ◽  
pp. E14 ◽  
Author(s):  
Dean Chou ◽  
Prakash Sampath ◽  
Henry Brem
Keyword(s):  
Vestibular Schwannoma ◽  
Cranial Nerve ◽  
Unusual Case ◽  
Case Reports ◽  
Clinical Entity ◽  
Vestibular Schwannomas ◽  
Presenting Symptoms ◽  
Cranial Nerve Dysfunction ◽  
Nerve Dysfunction ◽  
Management Issues

Hemorrhagic vestibular schwannomas are rare entities, with only a few case reports in the literature during the last 25 years. The authors review the literature on vestibular schwannoma hemorrhage and the presenting symptoms of this entity, which include headache, nausea, vomiting, sudden cranial nerve dysfunction, and ataxia. A very unusual case is presented of a 36-year-old man, who unlike most of the patients reported in the literature, had clinically silent vestibular schwannoma hemorrhage. The authors also discuss the management issues involved in more than 1000 vestibular schwannomas treated at their institution during a 25-year period.

Rehabilitation of Lower Cranial Nerve Dysfunction

2005 ◽  
Vol 8 (1) ◽  
pp. 50-53
Author(s):  
Timothy D. Anderson ◽  
Eva Michalakis ◽  
Peter Catalano
Keyword(s):  
Cranial Nerve ◽  
Lower Cranial Nerve ◽  
Cranial Nerve Dysfunction ◽  
Nerve Dysfunction

Cranial nerve dysfunction following Gamma Knife surgery for pituitary adenomas: long-term incidence and risk factors

2012 ◽  
Vol 116 (6) ◽  
pp. 1304-1310 ◽  
Author(s):  
Christopher P. Cifarelli ◽  
David J. Schlesinger ◽  
Jason P. Sheehan
Keyword(s):  
Risk Factors ◽  
Gamma Knife ◽  
Pituitary Adenomas ◽  
Cranial Nerve ◽  
Maximal Dose ◽  
Visual Dysfunction ◽  
Cranial Nerve Dysfunction ◽  
Nerve Dysfunction

Object Gamma Knife surgery (GKS) has become a significant component of neurosurgical treatment for recurrent secretory and nonsecretory pituitary adenomas. Although the long-term risks of visual dysfunction following microsurgical resection of pituitary adenomas has been well studied, the comparable risk following radiosurgery is not well defined. This study evaluates the long-term risks of ophthalmological dysfunction following GKS for recurrent pituitary adenomas. Methods An analysis of 217 patients with recurrent secretory (n = 131) and nonsecretory (n = 86) pituitary adenomas was performed to determine the incidence of and risk factors for subsequent development of visual dysfunction. Patients underwent ophthalmological evaluation as part of post-GKS follow-up to assess for new or worsened cranial nerve II, III, IV, or VI palsies. The median follow-up duration was 32 months. The median maximal dose was 50 Gy, and the median peripheral dose was 23 Gy. A univariate analysis was performed to assess for risk factors of visual dysfunction post-GKS. Results Nine patients (4%) developed new visual dysfunctions, and these occurred within 6 hours to 34 months following radiosurgery. None of these 9 patients had tumor growth on post-GKS neuroimaging studies. Three of these patients had permanent deficits whereas in 6 the deficits resolved. Five of the 9 patients had prior GKS or radiotherapy, which resulted in a significant increase in the incidence of cranial nerve dysfunction (p = 0.0008). An increased number of isocenters (7.1 vs 5.0, p = 0.048) was statistically related to the development of visual dysfunction. Maximal dose, margin dose, optic apparatus dose, tumor volume, cavernous sinus involvement, and suprasellar extension were not significantly related to visual dysfunction (p >0.05). Conclusions Neurological and ophthalmological assessment in addition to routine neuroimaging and endocrinological follow-up are important to perform following GKS. Patients with a history of radiosurgery or radiation therapy are at higher risk of cranial nerve deficits. Also, a reduction in the number of isocenters delivered, along with volume treated, particularly in the patients with secretory tumors, appears to be the most reasonable strategy to minimize the risk to the visual system when treating recurrent pituitary adenomas with stereotactic radiosurgery.

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