The rationale, indications, and surgical results of microvascular decompression for the treatment of vertigo are reviewed, and a critical analysis is made. The syndrome of disabling positional vertigo is discussed. It is concluded that (1) vascular compressive vestibular neuropathy may exist, (2) the current published diagnostic criteria for this disorder are insufficient to firmly establish the diagnosis, and (3) further work delineating this syndrome should be undertaken.
Get full access to this article
View all access options for this article.
References
1.
DandyWE. Ménière's disease. Its diagnosis and a method of treatmentArch Surg1928;16:1127–52
2.
DandyWE. Concerning the cause of trigeminal neuralgiaAm J Surg1934;24:447–55
3.
JannettaPJ. Arterial compression of the trigeminal nerve at the pons in patients with trigeminal neuralgiaJ Neurosurg1970;26:159–62
4.
JannettaPJ. Microsurgical approach to the trigeminal nerve for tic douloureuxProg Neurol Surg1976;7:180–200
5.
JannettaPJ. Observations on the etiology of trigeminal neuralgia, hemifacial spasm, acoustic nerve dysfunction and glossopharyngeal neuralgia. Definite microsurgical treatment and results in 117 patientsNeurochirurgia (Stuttg)1977;20:145–54
6.
JannettaPJ. Neurovascular cross-compression in patients with hyperactive dysfunction symptoms of the eighth cranial nerveSurg Forum1975;26:467–8
MøllerMBMøllerAR. Vascular compression syndrome of the eighth nerve: Clinical correlations and surgical findingsNeurol Clin1990;8:421–39
9.
JannettaPJMøllerMBMøllerARSekharLN. Neurosurgical treatment of vertigo by microvascular decompression of the eighth cranial nerveClin Neurosurg1986;33:645–65
10.
OhashiNYasumuraSNakagawaHMizukoshiKKuzeS. Vascular cross-compression of the VIIth and VIIIth cranial nervesJ Laryngol Otol1992;106:436–9
11.
Ter BruggenJPKeunenRwmTijssenCCWijnaldaD. Octavus nerve neurovascular compression syndromeEur Neurol1987;27:82–7
12.
AdamsCbt. Microvascular compression: An alternative view and hypothesisJ Neurosurg1989;57:1–12
13.
BrandtT. Positional and positioning vertigo and nystagmusJ Neurol Sci1990;95:3–28
14.
HardyDGRhotonALJr. Microsurgical relationship of the superior cerebellar artery and the trigeminal nerveJ Neurosurg1978;49:669–78
15.
SunderlandS. Neurovascular relations and anomalies at the base of the brainJ Neurol Neurosurg Psychiatry1948;11:243–57
16.
MøllerAR. The cranial nerve vascular compression syndrome. II. A review of pathophysiologyActa Neurochir1991;113:24–30
17.
FrommGHChatthaASTerrenceCFClassJD. Role of inhibitory mechanism in trigeminal neuralgiaNeurology1981;31:683–7
18.
JannettaPJ. Treatment of trigeminal neuralgia by microoperative decompression In: YoumansJR, ed. Neurological surgery.2nd ed.Vol 6. Philadelphia: WB Saunders, 1982:3589–603
19.
MøllerMBMøllerARJannettaPJ. Diagnosis and surgical treatment of disabling positional vertigoJ Neurosurg1986;64:21–8
20.
TaarnhøjP. The place of decompression of the posterior root in the treatment of trigeminal neuralgiaJ Neurol Neurosurg Psychiatry1961;24:295–6
21.
MøllerMBMøllerAR. Audiometric abnormalities in hemifacial spasm (HFS)Audiology1985;24:396–405
22.
TarlovEC. Microsurgical vestibular nerve section for intractable Ménière's syndrome — technique and resultsClin Neurosurg1986;33:667–84
23.
PhilipsC. Headache in general practiceHeadache1977;16:322–9
24.
WatersWE. Community studies of the prevalence of headacheHeadache1970;9:178–86
25.
WatersWE. The Pontypridd headache surveyHeadache1974;14:81–90
26.
AtkinsonM. Meniere's syndrome and migraine: Observations on common causal relationshipsAnn Intern Med1943;18:797–808
27.
OlssonJE. Neurotologic findings in basilar migraineLaryngoscope1991;101:1–41
28.
MøllerAR. Use of zero-phase digital filters to enhance brainstem auditory evoked potentials (BAEPs)Electroenceph Clin Neurophysiol1988;71:226–32
CoatsAC. Human auditory nerve action potentials and brainstem evoked responses. Latency-intensity function in detection of cochlear and retrocochlear abnormalitiesArch Otolaryngol1978;104:709–17
31.
CoatsACMartinJL. Human auditory nerve action potentials and brain stem evoked responses. Effects of audiogram shape and lesion locationArch Otolaryngol1977;103:605–22
32.
ThomsonJBrefiauPTosMJohnsonNJ. Placebo effect in surgery for Menière's diseaseArch Otolaryngol1981;107:271–7
