Berra Luigi Valentino, Di Cristanziano Francesca, Santoro Antonio
Department of Human Neurosciences, Neurosurgery, Sapienza University, Rome, Italy.
Surg Neurol Int. 2025 Apr 25;16:153. doi: 10.25259/SNI_55_2025. eCollection 2025.
Neurovascular conflict (NVC) is described as a pathological contact between cranial nerves and vessels. Glossopharyngeal neuralgia (GPN) and hypoglossal nerve palsy (HNP) due to NVC represent rare clinical entities. To our knowledge, we present the first reported case of concomitant GPN and HNP caused by vertebral artery (VA)-posterior inferior cerebellar artery (PICA) complex compression.
We report an extremely rare case of a 52-year-old man with combined unilateral left-sided GPN and HNP because of NVC involving both the VA and the PICA, successfully treated with a retrosigmoid approach for microvascular decompression (MVD). Postoperatively, the patient immediately recovered without new-onset dysfunction of lower cranial nerves, and a complete remission of symptoms was achieved.
As far as we know, in this article, we present the first singular case in the literature of concomitant classical GPN and HNP due to NVC involving both the VA and the PICA. Despite the low incidence of GPN and HNP, clinical picture and intraoperative findings represent clear and reliable elements for their diagnosis. MVD is a successful therapeutic strategy that offers a long-term cure for GPN and HNP.
神经血管冲突（NVC）被描述为颅神经与血管之间的病理性接触。由NVC引起的舌咽神经痛（GPN）和舌下神经麻痹（HNP）是罕见的临床病症。据我们所知，我们报告了首例由椎动脉（VA）-小脑后下动脉（PICA）复合体压迫导致的GPN和HNP并存的病例。
我们报告了一例极为罕见的52岁男性病例，因涉及VA和PICA的NVC导致单侧左侧GPN和HNP合并出现，通过乙状窦后入路进行微血管减压术（MVD）成功治疗。术后，患者立即康复，未出现新的下颅神经功能障碍，症状完全缓解。
据我们所知，在本文中，我们报告了文献中首例因涉及VA和PICA的NVC导致经典GPN和HNP并存的独特病例。尽管GPN和HNP发病率较低，但临床表现和术中发现是其诊断的明确且可靠的依据。MVD是一种成功的治疗策略，可为GPN和HNP提供长期治愈效果。
