Brainstem compression by 'kissing vertebral arteries'

摘要

We report a case of brainstem compression from bilateral and enlarged vertebral arteries (VA) in a 55-year-old man with pyramidal tract signs and lower cranial nerve palsy typically seen in this disease process.Our patient developed dysartliria, dysphagia, and unsteady gait over the previous 2 years. MR1 andangiography showed brainstem compression by the VA (figure).Vascular decompression was performed with the creation of a Gore-tex sling around the VA and subsequent improvement in our patient's symptoms.Bilateral brainstem compression by "kissing vertebral arteries" is extremely rare.' Brainstem decompression can be achieved with transposition of the VA.