Microvascular decompression for XXXX associated with bilateral vertebral artery compression.

@entity1 @entity2473 @entity5487 @entity3541 @entity393 @entity1649
BACKGROUND: Microvascular decompression (MVD) has been established as an effective treatment for @entity1649 ( @entity1649 ). However, replacement of bilateral vertebral arteries (VAs) from the root exit zone (REZ) is difficult and requires special techniques. Since reports of @entity1649 cases associated with bilateral VA compression are quite rare, the characteristics of these arteries and methods for safe and definite decompression were investigated. METHODS: Among 131 @entity1 who underwent MVD for @entity1649 , 33 @entity1 (25.2%) had associated VA compression. Four @entity1 (3.1%) had bilateral VA compression. Sufficient dissection of the arachnoid membrane allowed good visualization around the REZ, and the dolichoectatic VAs were successfully transposed and fixed to the nearby dura in three cases. RESULTS: The offending arteries were bilateral VAs plus the posterior @entity5487 (PICA) in two cases, bilateral VAs plus the anterior @entity5487 (AICA)-PICA in one case, and bilateral VAs in one case. In three @entity1 , the contralateral VA of the symptomatic side was more ectatic, dolichoectatic, and tougher than the ipsilateral VA and was difficult to remove. Three @entity1 treated with the transposition method experienced complete resolution of @entity2473 immediately after surgery. One @entity1 treated with the interposition method had minimal residual @entity2473 . Transient @entity3541 developed in one case, and moderate @entity393 developed in another case. CONCLUSIONS: Although @entity1649 caused by bilateral VA compression is rare, replacement of VAs from the REZ is not easy, because such VAs are invariably dolichoectatic and tough. Treatment of such cases requires special techniques.
