Zusammenfassung
Gegenüber den Raumforderungen stellen vaskuläre Veränderungen des Kleinhirnbrückenwinkels eher eine Ausnahme dar. Trigeminusneuralgie, hemifazialer Spasmus und Schwindel oder Tinnitus können bei Irritationen des Nervus trigeminus, facialis und vestibulocochlearis auftreten. Schlingenbildungen der Gefäße in den Kleinhirnzisternen können eine Kompression der Eintritts- oder Austrittszonen der Hirnnerven V, VII und VIII am Hirnstamm hervorrufen, was als „Vascular-loop-Syndrom“ bezeichnet wird. Zu Verlagerungen und Kompressionen von Hirnnerven und Hirnstamm können, wenn auch seltener, die Megadolichobasilaris und Aneurysmen des vertebrobasilären Systems führen. Bezüglich der Bildgebung ist die Magnetresonanztomographie (MRT) die Methode der Wahl. Die 3D-CISS-Sequenz und die MR-Angiographie sind hilfreich zur Darstellung der neurovaskulären Kompression. Die Methode der mikrovaskulären Dekompression ist eine wirkungsvolle Methode zur Beseitigung gefäßbedingter Kompressionen der Hirnnerven V, VII und VIII.
Abstract
Vascular anomalies of the cerebellopontine angle are rare compared to tumors in this area. Irritation of the trigeminal, facial, or vestibulocochlear nerve may cause trigeminal neuralgia, hemifacial spasm and vertigo, or tinnitus accordingly. Vessel loops in the cerebellopontine cisterns may cause compression at the root entry or exit zone of the cranial nerves V, VII, and VIII, a phenomenon which is called “vascular loop syndrome.” Megadolichobasilar artery and aneurysms of the vertebrobasilar system can also lead to dislocation and compression of the cranial nerves and brain stem. Three-dimensional CISS MR imaging and MR angiography are useful in the detection of neurovascular compression. Microvascular decompression is an effective surgical procedure in the management of compression syndromes of the cranial nerves V, VII, and VIII.
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Papanagiotou, P., Grunwald, I.Q., Politi, M. et al. Vaskuläre Erkrankungen des Kleinhirnbrückenwinkels. Radiologe 46, 216–223 (2006). https://doi.org/10.1007/s00117-005-1327-6
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DOI: https://doi.org/10.1007/s00117-005-1327-6
Schlüsselwörter
- Kleinhirnbrückenwinkel
- Neurovaskuläre Kompression
- Magnetresonanztomographie (MRT)
- Trigeminusneuralgie
- Hemifazialer Spasmus