Vertebral Artery Compression Syndrome Vertebral Artery Medullary Compression Syndrome

1. Vertebral Artery Compression Syndrome
Ade Wijaya, MD – October 2022

2. Introduction
• Vertebrobasilar dolichoectasia, or intracranial arterial
dolichoectasia, is an uncommon neurovascular
disorder characterized by elongation and enlargement
of the vertebrobasilar arteries. Basilar artery diameter
at the midpons >4.5 mm was considered dolichoectasic
• Associated with subsequent strokes,
microembolization, brainstem, and cranial nerve
compression
• Rare; more common in female and elderly
Li Q, Xie P, Yang WS, Yan B, Davis S, Caplan LR. Vertebral artery compression syndrome. Frontiers in Neurology. 2019 Oct 15;10:1075.
Kutty RK, Yamada Y, Takizawa K, Kato Y. Medullary Compression Due to Ectatic Vertebral Artery—Case Report and Review of Literature. Journal of Stroke and Cerebrovascular Diseases. 2020 Jan 1;29(1):104460.
Lombarski L, Kunert P, Skawiński M, Prokopienko M, Lewandowski Z, Marchel A. Symptomatic medulla compression by vertebral artery. neurologia i neurochirurgia polska. 2018;52(4):519-27.

3. Clinical Manifestation
• Dizziness
• Vertigo
• Ataxia
• Dysarthria
• Dysphagia
• Progressive or acute paralysis
• Hemisensory loss
• Cervical myelopathy
Li Q, Xie P, Yang WS, Yan B, Davis S, Caplan LR. Vertebral artery compression syndrome. Frontiers in Neurology. 2019 Oct 15;10:1075.
Lombarski L, Kunert P, Skawiński M, Prokopienko M, Lewandowski Z, Marchel A. Symptomatic medulla compression by vertebral artery. neurologia i neurochirurgia polska. 2018;52(4):519-27.

4. Neuroimaging (MRI)
Li Q, Xie P, Yang WS, Yan B, Davis S, Caplan LR. Vertebral artery compression syndrome. Frontiers in Neurology. 2019 Oct 15;10:1075.

5. Neuroimaging (MRI)
Li Q, Xie P, Yang WS, Yan B, Davis S, Caplan LR. Vertebral artery compression syndrome. Frontiers in Neurology. 2019 Oct 15;10:1075.

6. Treatment
• Individualized
• Consider microvascular decompression
Kim P, Ishijima B, Takahashi H, Shimizu H, Yokochi M. Hemiparesis caused by vertebral artery compression of the medulla oblongata. Case report. J Neurosurg. (1985) 62:425–9. doi: 10.3171/jns.1985.62.3.0425
Lombarski L, Kunert P, Skawiński M, Prokopienko M, Lewandowski Z, Marchel A. Symptomatic medulla compression by vertebral artery. neurologia i neurochirurgia polska. 2018;52(4):519-27.

7. Summary
• Vertebrobasilar dolichoectasia can compress
brainstem or spinal cord  Vertebral Artery
Compression Syndrome
• Rare
• Clinical presentation: vestibular, cerebellar or
pyramidal systems symptoms
• Treatment option: microvascular
decompression

8. THANK YOU