Neurovascular compression of the left rostral ventrolateral medulla: clinic findings and surgical result
MetadataShow full item record
Neurovascular compression syndromes of the rostral ventrolateral (RVL) medulla occur rarely. These syndromes reveal different clinical symptoms such as trigeminal neuralgia, hemifacial spasm, and glossopharyngeal neuralgia. We presented a case of 49-year-old male patient with left-sided trigeminal neuralgia, hemifacial spasm, and arterial hypertension. Magnetic resonance imaging (MRI) and angiography (MRA) showed a large tortuous basilar artery. Microvascular decompression (MVD) was successfully performed to decompress the nerves and the RVL medulla oblongata. Postoperatively, the patient had no trigeminal neuralgia and hemifacial spasm and his arterial blood pressure measurements were in normal limits without medication. An elongated basilar artery with compression of the brainstem is a much rarer condition. Our case demonstrated that if the patients have cranial neuropathies with arterial hypertension such as trigeminal neuralgia, hemifacial spasm, glossopharyngeal neuralgia, the patients should be carefully examined and profoundly evaluated with thin slice MRI especially posterior fossa. We emphasize that MVD is the gold standard in neurovascular compression syndromes.