Vascular compression of the medulla oblongata by the vertebral artery: Report of two cases

OBJECTIVE AND IMPORTANCE: Compression of the medulla oblongata by a tortuou s vertebral artery is rare. We report two patients with this lesion who wer e treated with vascular decompression of the vertebral artery. CLINICAL PRESENTATION: A 36-year-old man developed right hemiparesis with l ower cranial nerve deficits, and a 47-year-old man developed left lower cra nial nerve deficits and left cerebellar dysfunction. In both patients, magn etic resonance imaging revealed a tortuous vertebral artery compressing the medulla oblongata. INTERVENTION: In both patients, the compressed medulla oblongata was treate d by detaching the vertebral artery from the medulla oblongata, shifting it , and anchoring it to the nearby dura mater. Postoperatively, both patients are asymptomatic and have returned to their previous jobs. CONCLUSION: Although compression of the medulla oblongata by a tortuous ver tebral artery is rare, it can cause brainstem dysfunction. Magnetic resonan ce imaging clearly revealed the vascular compression in these patients. Sur gical treatment was effective. The symptoms related to a tortuous vertebral artery and some techniques for surgical treatment are discussed. Awareness of this rare lesion is necessary to ensure appropriate treatment.