Vascular compression of the eighth cranial nerve as a cause of vertigo. 1991

M B Møller
Department of Neurological Surgery, University of Pittsburgh School of Medicine, PA.

Some patients have vertigo that is more or less constant, associated with varying degrees of nausea, and only relieved by bedrest. This disorder, named disabling positional vertigo (DPV), was found to be caused by a blood vessel or vessels compressing the eighth cranial nerve in its intracranial portion, and it can be relieved by microvascular decompression (MVD) of the nerve. Important in the differential diagnosis of DPV are a detailed history, the results of audiometry (10 to 15 dB interaural threshold difference or a small mid-frequency notch), acoustic middle ear reflex response testing (may be abnormal), and recordings of brainstem auditory evoked potentials (BAEP). BAEP in such cases show increased conduction time in the auditory nerve and/or prolonged latency of wave V recorded from the contralateral ear, possibly the result of brainstem compression. Abnormalities on vestibular testing often do not reflect the severity of the illness. Forty-one patients who underwent MVD to treat DPV in one year at the author's institution have been followed for 4.5 to 5.5 years. By self-evaluation, 20 had excellent and 10 good results of the operation. The success of this procedure is even higher today, since it was found that very small blood vessels, including veins, can cause DPV; thus all vessels touching the nerve are now managed. Complications of MVD are rare. The most frequent, hearing loss, occurred in only one patient in this series.

UI MeSH Term Description Entries
D009408 Nerve Compression Syndromes Mechanical compression of nerves or nerve roots from internal or external causes. These may result in a conduction block to nerve impulses (due to MYELIN SHEATH dysfunction) or axonal loss. The nerve and nerve sheath injuries may be caused by ISCHEMIA; INFLAMMATION; or a direct mechanical effect. Entrapment Neuropathies,Nerve Entrapments,External Nerve Compression Syndromes,Internal Nerve Compression Syndromes,Nerve Compression Syndromes, External,Nerve Compression Syndromes, Internal,Compression Syndrome, Nerve,Compression Syndromes, Nerve,Entrapment, Nerve,Entrapments, Nerve,Nerve Compression Syndrome,Nerve Entrapment,Neuropathies, Entrapment,Neuropathy, Entrapment,Syndrome, Nerve Compression,Syndromes, Nerve Compression
D001921 Brain The part of CENTRAL NERVOUS SYSTEM that is contained within the skull (CRANIUM). Arising from the NEURAL TUBE, the embryonic brain is comprised of three major parts including PROSENCEPHALON (the forebrain); MESENCEPHALON (the midbrain); and RHOMBENCEPHALON (the hindbrain). The developed brain consists of CEREBRUM; CEREBELLUM; and other structures in the BRAIN STEM. Encephalon
D003937 Diagnosis, Differential Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000159 Vestibulocochlear Nerve The 8th cranial nerve. The vestibulocochlear nerve has a cochlear part (COCHLEAR NERVE) which is concerned with hearing and a vestibular part (VESTIBULAR NERVE) which mediates the sense of balance and head position. The fibers of the cochlear nerve originate from neurons of the SPIRAL GANGLION and project to the cochlear nuclei (COCHLEAR NUCLEUS). The fibers of the vestibular nerve arise from neurons of Scarpa's ganglion and project to the VESTIBULAR NUCLEI. Cranial Nerve VIII,Eighth Cranial Nerve,Cochleovestibular Nerve,Statoacoustic Nerve,Cochleovestibular Nerves,Cranial Nerve VIIIs,Cranial Nerve, Eighth,Cranial Nerves, Eighth,Eighth Cranial Nerves,Nerve VIIIs, Cranial,Nerve, Cochleovestibular,Nerve, Eighth Cranial,Nerve, Statoacoustic,Nerve, Vestibulocochlear,Nerves, Cochleovestibular,Nerves, Eighth Cranial,Nerves, Statoacoustic,Nerves, Vestibulocochlear,Statoacoustic Nerves,VIIIs, Cranial Nerve,Vestibulocochlear Nerves
D014717 Vertigo An illusion of movement, either of the external world revolving around the individual or of the individual revolving in space. Vertigo may be associated with disorders of the inner ear (EAR, INNER); VESTIBULAR NERVE; BRAINSTEM; or CEREBRAL CORTEX. Lesions in the TEMPORAL LOBE and PARIETAL LOBE may be associated with FOCAL SEIZURES that may feature vertigo as an ictal manifestation. (From Adams et al., Principles of Neurology, 6th ed, pp300-1) CNS Origin Vertigo,Central Nervous System Origin Vertigo,Positional Vertigo,Spinning Sensation,Vertigo, Brain Stem,Vertigo, Brainstem,Vertigo, Central Nervous System Origin,Vertigo, Central Origin,Vertigo, Constant,Vertigo, Essential,Vertigo, Intermittant,Vertigo, Paroxysmal,Vertigo, Peripheral,Vertigo, Subjective,Brain Stem Vertigo,Brain Stem Vertigos,Brainstem Vertigo,Brainstem Vertigos,CNS Origin Vertigos,Central Origin Vertigo,Central Origin Vertigos,Constant Vertigo,Constant Vertigos,Essential Vertigo,Essential Vertigos,Intermittant Vertigo,Intermittant Vertigos,Origin Vertigo, CNS,Origin Vertigo, Central,Origin Vertigos, CNS,Origin Vertigos, Central,Paroxysmal Vertigo,Paroxysmal Vertigos,Peripheral Vertigo,Peripheral Vertigos,Sensation, Spinning,Sensations, Spinning,Spinning Sensations,Subjective Vertigo,Subjective Vertigos,Vertigo, CNS Origin,Vertigo, Positional,Vertigos,Vertigos, Brain Stem,Vertigos, Brainstem,Vertigos, CNS Origin,Vertigos, Central Origin,Vertigos, Constant,Vertigos, Essential,Vertigos, Intermittant,Vertigos, Paroxysmal,Vertigos, Peripheral,Vertigos, Subjective
D016057 Evoked Potentials, Auditory, Brain Stem Electrical waves in the CEREBRAL CORTEX generated by BRAIN STEM structures in response to auditory click stimuli. These are found to be abnormal in many patients with CEREBELLOPONTINE ANGLE lesions, MULTIPLE SCLEROSIS, or other DEMYELINATING DISEASES. Acoustic Evoked Brain Stem Potentials,Auditory Brain Stem Evoked Responses,Brain Stem Auditory Evoked Potentials,Evoked Responses, Auditory, Brain Stem,Acoustic Evoked Brain Stem Potential,Acoustic Evoked Brainstem Potential,Acoustic Evoked Brainstem Potentials,Auditory Brain Stem Evoked Response,Auditory Brain Stem Response,Auditory Brain Stem Responses,Auditory Brainstem Evoked Response,Auditory Brainstem Evoked Responses,Auditory Brainstem Responses,Brain Stem Auditory Evoked Potential,Brainstem Auditory Evoked Potential,Brainstem Auditory Evoked Potentials,Evoked Potential, Auditory, Brainstem,Evoked Potentials, Auditory, Brainstem,Evoked Response, Auditory, Brain Stem,Evoked Response, Auditory, Brainstem,Evoked Responses, Auditory, Brainstem,Auditory Brainstem Response,Brainstem Response, Auditory,Brainstem Responses, Auditory,Response, Auditory Brainstem,Responses, Auditory Brainstem

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