1. Successful Treatment with Microvascular Decompression Surgery of a Patient with Hemiparesis Caused by Vertebral Artery Compression of the Medulla Oblongata: Case Report and Review of the Literature
- Author
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Hang Wang, Xuegang Niu, Jibin Ren, Yunfeng Diao, Hongtao Sun, Zhengjun Wei, and Fei Yuan
- Subjects
medicine.medical_specialty ,Medullary cavity ,medicine.medical_treatment ,Vertebral artery ,Microvascular decompression ,Microvascular Decompression Surgery ,03 medical and health sciences ,0302 clinical medicine ,medicine.artery ,Evoked Potentials, Somatosensory ,Medicine ,Humans ,Evoked potential ,Vertebral Artery ,Aged ,Medulla Oblongata ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,Evoked Potentials, Motor ,Magnetic Resonance Imaging ,Surgery ,Cerebral Angiography ,Paresis ,Cerebrovascular Disorders ,Hemiparesis ,Treatment Outcome ,030220 oncology & carcinogenesis ,Medulla oblongata ,Female ,Neurology (clinical) ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Magnetic Resonance Angiography - Abstract
Background There are few reports on hemiparesis caused by vascular medullary compression, which can occur because of dolichoectasia of the vertebrobasilar arterial system. In this article, we report a case of vertebral artery compression of the medulla oblongata in a 67-year-old woman. Case Description The patient was hypertensive, and she developed hemiparesis and intermittent spasms over 5 years. These spasms had worsened during the last year. Cranial nerve magnetic resonance imaging showed compression of the medulla oblongata by the left vertebral artery. A motor evoked potential (MEP) examination showed abnormal conduction of MEPs of bilateral toe abductors. The patient underwent microvascular decompression surgery under general anesthesia through a retrosigmoid keyhole approach. This operation led to relief of vascular compression and symptomatic improvement. Conclusions Our case suggests that detailed history, imaging studies, and electrophysiologic studies help lead to a correct and early diagnosis of hemiparesis caused by vascular compression of the rostral ventrolateral medulla. Microvascular decompression surgery improves patient symptoms, and intraoperative electrophysiologic monitoring helps to avoid injury to important adjacent nerves.
- Published
- 2017