Session Title: Virtual Poster Hall
Session Time: None. Available on demand.
Disclosures: Jonathan Chapekis, DO: No financial relationships or conflicts of interest
Case Description: The patient reports that the symptoms did not resolve with any treatment or medication. The dizziness was very intense and prevented him from doing his everyday activities. He was found to have vertebrobasilar dolichoectasia (VBD) on MRI. He underwent a craniotomy with decompression of the cranial nerves and placement of a protective stent. The patient tolerated the procedure well without any complications.
Patient: A 72-year-old male with past history of unrelated hearing loss presents with dizziness, tinnitus, and vision loss for worsening 6 months. Assessment/
Results: Post-operatively, the patients’ symptoms gradually improved. After receiving acute rehab, he was discharged home and resumed his prior level of function. He did still have some tinnitus but both the dizziness and tinnitus had greatly improved.
Discussion: This is a report of a rare case in which a compression of cranial nerve 8 was treated successfully with surgical intervention and rehabilitation. VBD is a rare dilative arteriopathy where the intracranial vertebral and/or basilar arteries become dilated, elongated and tortuous resulting in pulsatile compression of nearby structures. Although there is no current data on the exact incidence of VBD in the general population, angiography and autopsy results suggest that the overall incidence is less than 0.05%. Most cases are asymptomatic. However, VBD may presents with symptoms due to (1) direct compression on cranial nerves causing cranial neuropathy, (2) direct compression on brainstem, (3) acute ischemia in the vertebrobasilar arterial territory and (4) fatal outcomes due to vascular rupture. The most common symptom is ischemic stroke (37-50%), followed by brainstem and cranial nerve compression (19.9%), cerebral hemorrhage (13.5%), and hydrocephalus (1.3%). The most common compression is of the trigeminal nerve root and facial nerve root.
Conclusion: VBD is a rare condition that can be debilitating. Surgery may be the only option for successful relief of the symptoms.
Level of Evidence: Level V
To cite this abstract in AMA style:Chapekis J, Lercara C, Mensch J. Vertebrobasilar Dolichoectasia with Compression of the Vestibulocochlear Nerve Causing Debilitating Dizziness and Tinnitus: A Case Report [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/vertebrobasilar-dolichoectasia-with-compression-of-the-vestibulocochlear-nerve-causing-debilitating-dizziness-and-tinnitus-a-case-report/. Accessed April 16, 2021.
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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/vertebrobasilar-dolichoectasia-with-compression-of-the-vestibulocochlear-nerve-causing-debilitating-dizziness-and-tinnitus-a-case-report/