Vestibulocochlear Symptoms Caused by Vertebrobasilar Dolichoectasia

Area of Science:

• Neurology
• Oto-neurotology
• Vascular Neurology

Background:

• Vertebrobasilar dolichoectasia (VBD) involves abnormal elongation and distension of the vertebrobasilar artery.
• VBD can lead to cranial nerve compression, resulting in various neurological symptoms.
• Vestibulocochlear manifestations, including hearing loss and vertigo, are potential, though less commonly recognized, symptoms of VBD.

Purpose of the Study:

• To summarize the vestibulocochlear manifestations observed in patients with VBD.
• To highlight the importance of comprehensive oto-neurotologic evaluation in VBD patients before treatment selection.

Main Methods:

• Retrospective review of four VBD patients presenting with vestibulocochlear symptoms.
• Confirmation of VBD using brain MRI and MRA.
• Analysis of patient data, medical history, imaging findings, and audiological/vestibular test results.

Main Results:

• Three patients experienced ipsilesional sensorineural hearing loss (SNHL).
• Three patients reported paroxysmal recurrent vertigo.
• Two patients presented with typewriter tinnitus.
• Imaging revealed VBD causing neurovascular compression of cranial nerves VII or VIII, correlating with symptoms.

Conclusions:

• Neurovascular compression by VBD can precipitate vestibulocochlear symptoms like SNHL, vertigo, and tinnitus.
• Prompt recognition and thorough radiologic evaluation are essential for unexplained audiovestibular symptoms.
• Oto-neurotologic assessment is critical for guiding appropriate medical or surgical management to potentially halt disease progression or improve symptoms.