Abstract
Neurovascular compression syndrome (NVCS) involves neuropathy due to intracranial blood vessels compressing the cranial nerves. NVCS of the eighth cranial nerve is less reportedly established as a clinical entity than that of the fifth and seventh cranial nerves. We report 17 cases of NVCS of the eighth cranial nerve and their clinical features.
Clinical symptoms and test findings among our subjects indicated that (1) most were aged more than 65 years, (2) were unilateral, (3) had intermittent tinnitus, (4) suffered attacks lasting a few seconds dozens of times a day, (5) experienced dizziness concomitantly with tinnitus, (6) aggrevated tinnitus and dizziness when tilting the head toward the affected side and looking downward (positional tinnitus, positional dizziness), (7) heard specific tinnitus sounds such as crackling differing from those in cochlear tinnitus, (8) had mild or no hearing loss, (9) were diagnosed with retrocochlear hearing disturbance due to an interpeak latency delay between waves I and III of the auditory brainstem response (ABR), (10) often had no nystagmus or canal paresis (CP), (11) were found in constructive interference steady state magnetic resonance imaging (CISS MRI) to have compression of the eighth cranial nerve by the vertebral artery (VA) or the anterior inferior cerebellar artery (AICA), (12) rarely had concomitant facial spasms, and (13) had tinnitus and dizziness markedly suppressed by carbamazepine.
With the number of elderly individuals continuing to increase, cases of NVCS due to arteriosclerotic changes in cerebral blood vessels are expected to increase, making it necessary to consider NVCS in elderly subjects with dizziness, tinnitus, and hearing loss.
