Vertigo caused by basilar artery compression of the eighth nerve.

Vascular compression syndromes in the posterior cranial fossa have become well described clinical entities, especially for the fifth and seventh cranial nerves. Jannetta has proposed vascular compression of the eighth nerve as the etiology of hearing loss, tinnitus, and vertigo in some patients. The case that follows illustrates a clear-cut example of vestibular symptoms arising from vascular compression of the eighth nerve. The patient involved had disabling peripheral vertigo refractory to medical management. Magnetic resonance imaging documented a tortuous basilar artery compressing the eighth nerve on the involved side. This was confirmed at surgery, and a selective section of the vestibular nerve provided complete relief of disabling symptoms and preservation of hearing. The authors describe the details of this case and the enigma of eighth nerve symptoms due to vascular compression.