An 80-year-old man presented with difficulty in swallowing and speaking which had progressed over one year. Neurological examination revealed right hypoglossal nerve palsy with ipsilateral atrophy (Picture A). Laryngoscopic examination was unremarkable. Slowly progressive dysarthria and dysphagia with tongue atrophy initially indicated motor neuron disease (MND), but needle electromyographic ex...

Objective: Optimal surgical indications for cochleovestibular neurovascular compression syndrome (CNVC) remain controversial. We examined the surgical indications and timing of surgery for CNVC. Methods: The surgical outcomes of 30 patients (32 sides) with vertigo, tinnitus and hearing loss were evaluated. CNVC was diagnosed according to five items for clinical features with a scoring system of...

The rostral ventrolateral medulla (RVLM) is considered a major center for the regulation of sympathetic and cardiovascular activities. Several clinical studies have indicated a possible causal relationship between neurovascular contact of the left RVLM and essential hypertension, and some investigators have suggested that the left RVLM is more sensitive to pulsatile compression than the right R...

Unilateral abducens nerve palsy with periodic recurrences is a well-recognised finding in children, but is rare in adults. The underlying pathophysiological mechanism is unknown. Vascular compression of the nerve is suspected but never demonstrated. We describe an adult patient with, altogether, 11 periods of unilateral right-sided abducens palsy and arterial contact at the root exit zone of th...

Popliteal entrapment syndrome caused by isolated popliteus muscle enlargement is very rare, although its occurrence has been reported after discrete trauma. However, popliteal artery stenosis with combined peroneal and proximal tibial neuropathy caused by popliteus muscle enlargement without preceding trauma has not been reported. A 57-year-old man presented with a tingling sensation and pain i...

During routine bilateral dissection of 64 upper limbs in 32 adult human cadavers, four cases of an axillary arch, a muscular anomaly, were found. In one case, the axillary arch presented on both sides and in two cases it presented unilaterally on the right side. The innervation and relationships of the axillary arches are reported and the surgical significance of the anomaly is discussed.

Superior oblique myokymia should be suspected in patients complaining of brief, recurrent episodes of monocular oscillopsia or blurred vision. Less often, patients complain of paroxysmal vertical or torsional diplopia. The abnormal eye movements are often difficult to appreciate but spasms of torsional-vertical rotation were seen easily in this patient. This case is not typical because the atta...

seen following repeated or prolonged hyperabduction of the arms. The sites of compression are thought to be the point at which these neurovascular structures emerge from beneath the pectoralis minor tendon and the interval between the clavicle and the first rib. Five patients presenting the hyperabduction syndrome have been subjected to pectoralis minor tenotomy and anterior scalenotomy with a ...

Neurovascular compression syndromes are caused by a pathological contact between cranial nerves and vascular structures at the surface of the brainstem. Aiming at improved pre-operative analysis of the target structures, we propose calculating distance fields to provide quantitative information of the important nerve-vessel contacts. Furthermore, we suggest reconstructing polygonal models for t...