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Updated: Dec 15, 2025

Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
Sixth cranial nerve palsy secondary to compression by dolichoectatic vertebrobasilar artery
Trishal Jeeva-Patel1, Edward A Margolin2, Daniel Mandell3
1Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.
Insights
A rare case shows dolichoectasia, an artery
Area of Science:
- Neurology
- Vascular Neurology
- Neuroimaging
Background:
- Dolichoectasia involves artery elongation, dilatation, and tortuosity.
- Vascular compression of cranial nerves can cause neurological deficits.
Abstract:
Dolichoectasia refers to distinct elongation, dilatation and tortuosity of an artery. We present a rare well-illustrated case of dolichoectatic vertebrobasilar artery compressing the cisternal portion of the sixth cranial nerve resulting in chronic sixth nerve palsy. High spatial resolution, three-dimensional, heavily T2-weighted MRI sequences are uniquely positioned to assess the cranial nerves especially in their cisternal and canalicular portions and need to be performed for all patients with non-resolving cranial nerve palsies. Dolichoectatic vessels can be the cause of neurovascular conflict and cause non-resolving oculomotor palsies.
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