• Yukiko Nakahara, Masatou Kawashima, Toshio Matsushima, Motofumi Kouguchi, Yukinori Takase, Yusuke Nanri, and Yusuke Yakusiji.
• Department of Neurosurgery, Saga University, Saga, Japan. Electronic address: nakahara@cc.saga-u.ac.jp.
• World Neurosurg. 2014 Sep 1;82(3-4):535.e11-6.

BackgroundIt is well known that brainstem dysfunction may be caused by vascular compression of the medulla oblongata (MO). However, only a limited number of reports have found microvascular decompression (MVD) surgery to be an effective treatment for symptomatic patients with MO dysfunction, such as essential hypertension, pyramidal tract signs, dysphagia, and respiratory failure.Case DescriptionThis report describes 3 patients with vertebral artery compression of MO who presented with respiratory failure and/or dysphagia. MVD surgery using the transcondylar fossa approach was effective in relieving patient symptoms.ConclusionsAlthough the pathogenic mechanisms of symptomatic vertebral artery compression of MO remain unclear, we should recognize that MVD surgery is effective for selected patients with brainstem dysfunction. The transcondylar fossa approach and the stitched sling retraction technique are appropriate in MVD surgery to relieve vertebral artery compression of MO.Copyright © 2014 Elsevier Inc. All rights reserved.

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