Vascular loop in the cerebellopontine angle: clinical-radiological correlation

The brainstem, situated in the posterior fossa, connects the brain to the spinal cord. Owing to its location, the nerves of the brainstem are closely related with vascular structures.

To correlate the finding of vascular loops in the cerebellopontine angle on imaging with symptoms indicative of vestibulocochlear involvement.

This retrospective descriptive study included all patients evaluated between 2011 and 2017 with findings suggestive of vascular loops in the cerebellopontine angle for whom the clinical history and imaging studies were available.

A total of 102 patients (63 women and 39 men) had vestibulocochlear involvement. The most common clinical indication was dizziness (41.18%). A unilateral vascular loop was found in 43 patients (right: 21.57%, left: 20.59%) and bilateral loops were found in 59 (57.84%) patients. The most common type of vascular loop was type II (right: 69.14%; left: 58.75%). The most common origin of vascular loops was the anterior inferior cerebellar artery (right: 66.67%, left: 65.00%). No associations were observed between vascular loops and sensorineural hearing, nystagmus, or vertigo. There was an association with tinnitus.

The presence of vascular loops is not associated with most auditory symptoms. Nevertheless, all findings on imaging studies must be reported. The interpretation of the findings of imaging studies must be correlated with the clinical symptoms after other more common causes that can explain the symptoms have been ruled out.