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Cochlear vertebral entrapment syndrome: a case report.

C H Liu1, S K Lin, Y J Chang

  • 1Department of Neurology, Chang Gung Memorial Hospital, 199, Tung Hwa North Road, Taipei, Taiwan, ROC.

European Journal of Radiology
|November 13, 2001
PubMed
Summary

A large vascular loop from vertebral dolichoectasia compressed the vestibulocochlear nerve, causing unilateral hearing loss. This case highlights cochlear vertebral entrapment syndrome as a cause of retrocochlear lesions.

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Area of Science:

  • Neurology
  • Vascular Neurology
  • Neurotology

Background:

  • Vascular loops can compress cranial nerves, but isolated vestibulocochlear nerve involvement is rare.
  • Vertebral dolichoectasia is an elongation and widening of the vertebral artery, which can lead to neurovascular compression.

Observation:

  • A patient presented with isolated unilateral hearing loss without other neurological deficits.
  • Neuroimaging revealed a large vascular loop from vertebral dolichoectasia impinging on the left vestibulocochlear nerve at the porus acusticus.
  • Brainstem auditory evoked potential studies indicated a retrocochlear lesion.

Findings:

  • Cerebral angiography confirmed a megadolichoectatic loop of the left vertebral artery.
  • The vascular loop caused mechanical compression of the vestibulocochlear nerve, leading to hearing loss.

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  • No brainstem infarction or vertebrobasilar atherosclerosis was identified.

    • Implications:

    • This case demonstrates cochlear vertebral entrapment syndrome as a distinct cause of hearing loss.
    • Early diagnosis through advanced neuroimaging is crucial for managing neurovascular compression syndromes.
    • Understanding such rare neurovascular interactions can improve diagnostic accuracy and treatment strategies for hearing impairment.