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Journal of neurosurgery · Oct 2017
Case ReportsResolution of intractable retching following mobilization of a dolichoectatic vertebral artery: case report of a unique brainstem-cranial nerve compression syndrome.
- Scott Seaman, Paul Nelson, Jacob Alexander, Andrew Swift, and James Fick.
- Department of Neurosurgery, Penn State University College of Medicine, University Park Regional Campus, Mount Nittany Medical Center.
- J. Neurosurg. 2017 Oct 1; 127 (4): 761-767.
AbstractThe authors present the case of a 53-year-old man who was referred with disabling retching provoked by left arm abduction. At the time of his initial evaluation, a cervical MRI study was available for review and revealed an anatomical variation of the ipsilateral juxtamedullary vertebrobasilar junction. After brain imaging revealed contact of the medulla by a dolichoectatic vertebral artery at the dorsal root entry zone of the glossopharyngeal and vagus nerves, the patient was successfully treated by microvascular decompression of the brainstem and cranial nerves. This case demonstrates how a dolichoectatic vertebral artery-a common anatomical variation that typically has no clinical consequence-should be considered in cases of cranial nerve dysfunction.
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