Microvascular decompression surgery for vertebral artery compression of the medulla oblongata: 3 cases with respiratory failure and/or dysphagia.
BACKGROUND
It is well known that brainstem dysfunction may be caused by vascular compression of the medulla oblongata (MO). However, only a limited number of reports have found microvascular decompression (MVD) surgery to be an effective treatment for symptomatic patients with MO dysfunction, such as essential hypertension, pyramidal tract signs, dysphagia, and respiratory failure.


METHODS
This report describes 3 patients with vertebral artery compression of MO who presented with respiratory failure and/or dysphagia. MVD surgery using the transcondylar fossa approach was effective in relieving patient symptoms.


CONCLUSIONS
Although the pathogenic mechanisms of symptomatic vertebral artery compression of MO remain unclear, we should recognize that MVD surgery is effective for selected patients with brainstem dysfunction. The transcondylar fossa approach and the stitched sling retraction technique are appropriate in MVD surgery to relieve vertebral artery compression of MO.
Department of Neurosurgery, Saga University, Saga, Japan. Electronic address: nakahara@cc.saga-u.ac.jp.
Yukiko
Y
Nakahara
Department of Neurosurgery, Saga University, Saga, Japan.
Masatou
M
Kawashima
Department of Neurosurgery, Saga University, Saga, Japan.
Toshio
T
Matsushima
Department of Neurosurgery, Saga University, Saga, Japan.
Motofumi
M
Kouguchi
Department of Neurosurgery, Saga University, Saga, Japan.
Yukinori
Y
Takase
Department of Neurology, Saga University, Saga, Japan.
Yusuke
Y
Nanri
Department of Neurology, Saga University, Saga, Japan.
Yusuke
Y
Yakusiji
D000328:Adult; D000368:Aged; D003680:Deglutition Disorders / Q000209:etiology*; D005260:Female; D006801:Humans; D020961:Lewy Body Disease / Q000150:complications; D008526:Medulla Oblongata / Q000601:surgery*; D061145:Microvascular Decompression Surgery / Q000379:methods*; D011712:Pyramidal Tracts / Q000473:pathology; D012131:Respiratory Insufficiency / Q000209:etiology*; D016896:Treatment Outcome; D014711:Vertebral Artery / Q000601:surgery; D014715:Vertebrobasilar Insufficiency / Q000150:complications / Q000601:surgery*
Medulla oblongata compression; Microvascular decompression surgery