title: Vascular compression of the medulla oblongata by the vertebral artery: report of two cases.
abstract: OBJECTIVE
  Compression of the medulla oblongata by a tortuous vertebral artery is rare. We report two patients with this lesion who were treated with vascular decompression of the vertebral artery.
  
  
  METHODS
  A 36-year-old man developed right hemiparesis with lower cranial nerve deficits, and a 47-year-old man developed left lower cranial nerve deficits and left cerebellar dysfunction. In both patients, magnetic resonance imaging revealed a tortuous vertebral artery compressing the medulla oblongata.
  
  
  METHODS
  In both patients, the compressed medulla oblongata was treated by detaching the vertebral artery from the medulla oblongata, shifting it, and anchoring it to the nearby dura mater. Postoperatively, both patients are asymptomatic and have returned to their previous jobs.
  
  
  CONCLUSIONS
  Although compression of the medulla oblongata by a tortuous vertebral artery is rare, it can cause brainstem dysfunction. Magnetic resonance imaging clearly revealed the vascular compression in these patients. Surgical treatment was effective. The symptoms related to a tortuous vertebral artery and some techniques for surgical treatment are discussed. Awareness of this rare lesion is necessary to ensure appropriate treatment.
authors.affiliation: Department of Neurological Surgery, Aichi Medical University, Nagakute, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Hongo
authors.forename: H
authors.initials: H
authors.lastname: Nakagawa
authors.forename: N
authors.initials: N
authors.lastname: Morota
authors.forename: M
authors.initials: M
authors.lastname: Isobe
mesh_terms: D000328:Adult; D002533:Cerebral Angiography; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000601:surgery*; D019299:Decompression, Surgical; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008526:Medulla Oblongata / Q000601:surgery*; D008875:Middle Aged; D014711:Vertebral Artery / Q000002:abnormalities* / Q000601:surgery