Neurovascular conflict in patient with tinnitus and essential hypertension: case report

The term neurovascular conflict (NVC) has been introduced to describe the anatomic situation where a nerve makes contact with a blood vessel, artery or vein, at the exit zone from the brain’s trunk. The NVC between the VIII nerve and a blood vessel is clinically associated with tinnitus, vertigo (disabling positional vertigo, DPV), and unilateral sensorineural hearing loss. The blood vessels which most frequently make contact with the VIII nerve are the anterior-inferior cerebellar artery, then the posterior-inferior cerebellar artery and the basilar artery. The authors present an unusual case in which both vertebral arteries (one of which crosses the midline) create a NVC with left acoustic nerve at the dimple side of the bulb, generating a clinical picture characterized by essential hypertension and left tinnitus that do not respond to any medical treatment.