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Case Report
Vertebrobasilar dolichoectasia: A rare presentation to the otolaryngologist
1 Core Surgical Trainee, Stockport NHS Foundation Trust, Stockport, United Kingdom
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Jessica Daniels
MBChB, MRes, Core Surgical Trainee, Stockport NHS Foundation Trust, Stockport,
United Kingdom
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Article ID: 100001Z18JD2020
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Daniels J, Rudic M. Vertebrobasilar dolichoectasia: A rare presentation to the otolaryngologist. J Case Rep Images Otolaryngol 2020;1:100001Z18JD2020.ABSTRACT
Introduction: Vertebrobasilar dolichoectasia (VBD) is a pathological process causing elongation, tortuosity, and dilation of blood vessels. When intracranial vessels are affected they can exert pressure on surrounding structures.
Case Report: A 50-year-old man presented with a six month history of left sided continuous, high pitched tinnitus, and hearing loss. A magnetic resonance imaging (MRI) scan revealed VBD causing deformation of the vestibulocochlear nerve and brain stem at the pontomedullary junction. The decision was taken not to intervene for two reasons; the symptoms were not affecting the patient′s quality of life, second, the vertebral artery was not abutting the vestibulocochlear nerve. He was managed conservatively and referred to the stroke team.
Conclusion: Vertebrobasilar dolichoectasia can present with multiple or isolated cranial neuropathies. As a rare cause of vestibulocochlear symptoms, VBD should be considered if symptoms cannot be explained. Vertebrobasilar dolichoectasia carries an increased risk of death from ischemic stroke, hemorrhagic stroke, and brain stem compression. Evidence-based treatments are lacking and there is no consensus on the optimal management. Randomized control trials are needed urgently to improve outcomes in this patient group.
Keywords: Ischemic stroke, Vertebrobasilar dolichoectasia, Vestibulocochlear neuropathy
SUPPORTING INFORMATION
Author Contributions
Jessica Daniels - Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Milan Rudic - Substantial contributions to conception and design, Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2020 Jessica Daniels et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
