[Vertigo due to neurovascular cross-compression: diagnosis and treatment].

Abstract

OBJECTIVE:

To explore the clinical characteristics, pathological mechanism, diagnose, differential diagnosis and the treatment of vascular compressive vestibular neuropathy.

METHOD:

The authors retrospectively studied 2 cases of vascular compressive vestibular neuropathy about clinical characteristics, auditory tests, vestibular tests and imaging examine results, pharmacotherapy results and reviewed the related documents.

RESULT:

There were some common clinical characteristics: (1) Vertigo and disequilibrium could be elicited by any physical activity and head movement and abated with complete bed rest; (2) Symptoms and signs can't be improved by vestibular suppressant medications; (3) When taken Dix-Hallpike test, true vertigo or a spinning sensation appeared during head movement, when head skilled at any position,the symptoms disappeared; (4) The suffering lateral often showed high frequency sensorineural hearing loss ,the ABR of the suffering lateral showed prolonged inter wave latency of I-III wave; (5) Vestibular tests showed central lesion; (6) Occupying lesion can be ruled out by CT and MRI, MRI showed neurovascular compression of vestibular nerve; (7) Taking carbamazepine plus baclofen or only Tegretol orally can alleviate symptoms. A great deal of surgeries confirmed neurovascular compression of cranial nerve U as a disease entity, the offending artery mainly anterior inferior cerebellar artery. Microvascular decompression of cranial nerve VIII can successfully relieve vertigo.

CONCLUSION:

Neurovascular compression of cranial nerve VIII is a disease entity beyond question. It's major characters were vertigo and disequilibrium which elicited by any physical activity and head movement, magnetic resonance tomographic angiography can give valuable information for diagnosis and treatment. Microvascular decompression can effectively relieve vertigo.

• Authors: Xiangli Zeng, Peng Li, Qingcong Kong, Yunya Lin, Ziming Wu
• Journal: Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology, head, and neck surgery (Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi) Vol. 24 Issue 16 Pg. 733-7 (Aug 2010) ISSN: 2096-7993 [Print] China
• PMID: 21033099 (Publication Type: Case Reports, English Abstract, Journal Article)

Topics

• Adult
• Decompression, Surgical
• Female
• Humans
• Microsurgery
• Middle Aged
• Nerve Compression Syndromes (complications, diagnosis, surgery)
• Retrospective Studies
• Vertigo (etiology)
• Vestibular Nerve (pathology)
• Vestibular Neuronitis (diagnosis, pathology, surgery)
• Vestibulocochlear Nerve (pathology)