Nerve Compression Syndromes in the Posterior Cranial Fossa

Area of Science:

• Neurosurgery
• Neurology

Background:

• Posterior cranial fossa nerve compression syndromes significantly impact patient quality of life.
• Uncertainty often surrounds the optimal treatment approach for these conditions.

Purpose of the Study:

• To provide an overview of posterior cranial fossa nerve compression syndromes.
• To outline current and surgical treatment strategies for these neurovascular compression syndromes.

Main Methods:

• Selective PubMed literature search.
• Analysis of the authors' clinical patient collective.

Main Results:

• Syndromes result from vascular compression of cranial nerves at the brainstem interface.
• Common conditions include trigeminal neuralgia and hemifacial spasm; less common are glossopharyngeal neuralgia, nervus intermedius neuralgia, and vestibular paroxysmia.
• Initial treatments involve anticonvulsants (e.g., carbamazepine) for trigeminal neuralgia and botulinum toxin for hemifacial spasm; microvascular decompression is indicated upon treatment failure.

Conclusions:

• Nerve compression syndromes in the posterior cranial fossa can be initially treated non-surgically.
• Microvascular decompression surgery is a causal and effective treatment option when conservative methods fail or cause side effects.