Brainstem and facial nerve compression syndromes due to vertebrobasilar dolichoectasia: A case report and literature review

摘要

Background Vertebrobasilar dolichoectasia (VBD) is a rare vasculopathy which is characterized by arterial elongation, dilation, and tortuosity. Current data regarding VBD are very limited. We present a case of VBD with brainstem compression syndrome and facial nerve palsy. Case presentation A 62-year-old Chinese male initially presented with left peripheral facial paralysis, left facial hypoesthesia around the mouth. A clinical diagnosis of vertebrobasilar dolichoectasia was made based on MRI and CTA, which showed an elongated and tortuous left vertebral artery. These symptoms partially improved following corticosteroids therapy, multivitamins and symptomatic supportive treatments. Conclusion Vertebrobasilar dolichoectasia is a very rare cause of brainstem and facial nerve compression, there is no effective treatment of the clinical symptoms. The pathogenesis and therapy of VBD needs further investigation. Highlights ? We report a case of patient characterized by left peripheral facial paralysis and left facial hypoesthesia, due to vertebrobasilar dolichoectasia firstly. ? Magnetic resonance imaging shows the flow void of left anterior inferior cerebellar artery(AICA)which is causing compression over left facial nerve. ? MRI and CTA images showed a tortuous and elongated vertebrobasilar artery.