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Case of the Month - January 2017

57 man  years. Pain in the oropharynx and in the right cervical region.

Magnetic Resonance Imaging in T2-FIESTA sequences  axial and coronal showing a vascular loop of the PICA in contact with the right ninth nerve.

Surgical management


The patient is taken to microvascular decompression through  a right inferior far-lateral mini suboccipital craniotomy approach,  with Teflon placement for the separation of the vascular loop. (Video and photo)

A microscope image is observed where the glossopharyngeal nerve can be seen  right (asterisk), the vascular loop pierces the right PICA (white arrow) and one of the branches of the right vagus nerve (white arrowhead).

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