title: Vertebral artery dolicoectasia with brainstem compression: role of microvascular decompression in relieving pyramidal weakness.
abstract: Vertebral artery dolicoectasia (VAD) can cause brainstem compression and dysfunction. Reports of pyramidal tract involvement by brainstem compression and the surgical benefits and its long-term results are sparsely reported. We hereby report three cases of medullary compression by VAD causing pyramidal weakness. Two patients with bilateral compression with quadriparesis did not want surgical treatment and were still disabled at 58 months and 50 months of follow-up, respectively. One patient with unilateral medullary compression with hemiparesis underwent microvascular decompression using Teflon sling retraction. This patient was relieved of symptoms and is asymptomatic at 14-month follow-up. This report emphasizes the need of surgical decompression in cases of brainstem compression by VAD with caution about appropriate case selection.
authors.affiliation: Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, India. nishanth46@gmail.com.|National Institute of Mental Health and Neurosciences, 2nd floor, Neurosciences faculty building, Bangalore, 560029, India. nishanth46@gmail.com.
authors.forename: Nishanth
authors.initials: N
authors.lastname: Sadashiva
authors.affiliation: Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, India.
authors.forename: Dhaval
authors.initials: D
authors.lastname: Shukla
authors.affiliation: Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, India.
authors.forename: Dhananjaya I
authors.initials: DI
authors.lastname: Bhat
authors.affiliation: Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, India.
authors.forename: Bhagavatula Indira
authors.initials: BI
authors.lastname: Devi
mesh_terms: D000328:Adult; D001927:Brain Diseases / Q000601:surgery*; D006801:Humans; D008297:Male; D008526:Medulla Oblongata / Q000601:surgery*; D061145:Microvascular Decompression Surgery / Q000379:methods*; D008875:Middle Aged; D016896:Treatment Outcome; D014711:Vertebral Artery / Q000002:abnormalities / Q000601:surgery*
keywords: Brainstem compression; Microvascular decompression; Vertebral artery ectasia