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Progressive bulbar symptomatology due to vascular brainstem compression
  1. Osman Younus1,
  2. Timothy Hampton2,3,
  3. Eli Silber1,4 and
  4. George Dervenoulas1
  1. 1Neurology, Lewisham and Greenwich NHS Trust, London, UK
  2. 2Radiology, Lewisham and Greenwich NHS Trust, London, UK
  3. 3Radiology, King's College Hospital, London, UK
  4. 4Neurology, King's College Hospital, London, UK
  1. Correspondence to Dr Osman Younus; osman.younus{at}


Symptomatic brainstem compression from vertebral artery dolichoectasia is rare. There are no recognised diagnostic or treatment criteria to guide management of this disease. We report a case of medullary compression and cerebral ischaemia from an enlarged and tortuous vertebral artery. Our patient developed progressive dysphonia and dysphagia. Cerebral MRI revealed compression of the medulla oblongata by a right ectatic vertebral artery and a right occipital lobe infarct. Other causes of bulbar dysfunction were ruled out. He was treated with anticoagulation and underwent percutaneous endoscopic gastrostomy. We review selected literature on the presentation, diagnosis and management of this rare neurologic condition.

  • neurology
  • brain stem / cerebellum
  • cranial nerves
  • neuroimaging
  • stroke

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  • Contributors All authors satisfy the ICMJE criteria for authorship.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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