NEUROSURGERY QUARTERLY, vol.18, no.1, pp.69-71, 2008 (SCI-Expanded)
Abnormal changes such as loops, tortuosity, and ectasia in vascular structures that form vertebrobasilar system can cause mechanical vascular-compression syndromes. Neurologic symptoms might be encountered by compression of one or more of these cranial nerves. The compression of 3 nerves together has not been reported in the literature. Here, we present a patient with facial pain, vertigo, and tinnitus associated with the vascular compression of 5, 7, and 8 cranial nerves. A 52-year-old man was admitted to the clinic with complaints of pain located in the left upper part of face, with tinnitus being prominent on the left, and positional vertigo developing occasionally. The physical and neurologic examinations were normal. Cerebral magnetic resonance imaging and magnetic resonance angiography showed tortuosity in both the vertebral arteries and in the basilar artery, as well as the external compression of trigeminal 5, 7, and 8 nerve complexes by the intradural segment of the left vertebral artery. Internal acoustic channel magnetic resonance imaging revealed the compression of the 7 and 8 nerve complexes by the left basilar artery.