Vascular compression syndrome in the cerebellopontine angle cistern

Case contributed by Dr Amro Omar

Presentation

Right tinnitus.

Patient Data

Age: 45
Gender: Male

Axial 3D-FIESTA MR images through the eighth CN show the following: AICA (Anterior inferior cerebellar artery) loop within the right IAC, vascular loop extending into >50% of the IAC (Type III).

Red arrow: AICA (Anterior inferior cerebellar artery) loop within the right IAC, vascular loop extending into >50% of the IAC (Type III).

Case Discussion

AICA loops in the cerebello-pontine cistern have been accused of causing auditory and vestibular symptoms, as well as hemifacial spasm, resulting from compression of the VII and VIII cranial nerves.

The vessels can be classified according to their anatomic location: 

  • type I, lying only in the CPA but not entering the internal auditory canal (IAC)
  • type II, entering but not extending >50% of the length of the IAC
  • type III, extending >50% of the IAC .

In addition, it is important to evaluate the presence of vascular contact and the angulation of eighth CN at the contact point as a sign of vascular compression.

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Case information

rID: 26338
Case created: 13th Dec 2013
Last edited: 15th Jun 2017
Inclusion in quiz mode: Included

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