{"id":"5311f332-ab1d-4188-bb02-2ab1c3d7975e","slug":"pulsatile-arterial-compression-of-cranial-nerves","title":"Pulsatile arterial compression of cranial nerves","authors":["Joyce S. Nicholas","Sunil J. Patel"],"abstract":"Background: Pulsatile arterial compression of the right ventrolateral medulla (VLM) has been hypothesized as a potential independent risk factor for type 2 diabetes mellitus. Previous studies have established a neurogenic basis for various cranial nerve hyperactive syndromes, with evidence suggesting that arterial compression may influence sympathetic outflow. This article presents observations from patients undergoing microvascular decompression for type 2 diabetes mellitus. Methods: The study involved a cohort of 10 patients who underwent retromastoid craniectomy with microvascular decompression of the right VLM and vagus nerve. Postoperative outcomes were assessed at the 12-month follow-up visit to evaluate glycemic control. Additional studies, including electrical stimulation, were conducted to define the location of sympatho-excitatory and inhibitory neuronal aggregates in humans. Results: Of the 10 patients, seven demonstrated improved or stable glycemic control at the 12-month follow-up. The study also highlighted that non-obese patients with type 2 diabetes mellitus appeared to respond better to decompression than their obese counterparts. The findings contribute to a growing body of evidence regarding the relationship between arterial compression and diabetes management. Conclusion: The observations made in this study provide a foundation for further investigation into the role of pulsatile arterial compression in type 2 diabetes mellitus. Continued research is encouraged to explore the specific mechanisms involved and to identify patient subgroups that may benefit from microvascular decompression. Keywords: pulsatile compression, ventrolateral medulla, type 2 diabetes, microvascular decompression, glycemic control, sympathetic outflow, cranial nerves","thumbnailUrl":null,"publishDate":"2010-07-16T00:00:00.000Z","doi":"10.4103/2152-7806.66458","categories":["Original Article"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2015/05/3205/SNI-1-28.pdf"}