Vestibulocochlear Symptoms Caused by Vertebral Arter Compression at the Cerebellopontine Angle: Is There Any Relationship?

Abstract

Purpose:To evaluate the vestibulocochlear symptoms and audiological findings in patients with radiologically detected vascular compression of the abnormally localized vertebral artery at the cerebellopontine angle. Materials and Methods: Patients with magnetic resonance imaging (MRI) with an image of vascular compression due to an angulated or lateralized vertebral artery included. The degree of vascular compression based on imaging was noted by the radiologist. The patients’ medical records were independently reviewed and the presence of tinnitus, hearing loss, vertigo and the results of mean hearing thresholds on pure tone average (PTA), speech discrimination (SD) mean scores, V latency, and I-V interpeak latency on auditory brainstem responses (ABR) were noted. Results: The close relationship was detected in 28 MR scans. The degree of compression was categorized as point compression on the nerve in 5 patients, longitudinal compression on the nerve in 17, and contact as vascular loop or indentation in the nerve in 6. There were no differences between vascular compression of vertebral artery and ipsilateral symptom patterns in all groups. In the groups, ipsilateral results of PTA, SD and ABR were found abnormal compared with contralateral results but failed to show statistical significance. Conclusion: The results suggest that there was no significant clinical value of vascular compression of the vertebral artery on the cochleovestibular nerve. In patients with unexplained hearing loss, dizziness and tinnitus complaints, deciding on the cause of compression of the vertebral artery at the cerebellopontine angle and discussing the necessity of decompression surgery will only be possible with larger patient series.

Keywords

• vascular compression
• vertebral artery
• mr imaging
• cochleovestibular signs