Meniere's symptoms due to neuro-vascular compression

Five patients with episodic vertigo, tinnitus and hearing loss were found to have compression of the eighth cranial nerve by small aneurysm or arterial loops.The characteristic symptoms in these patients were :1) Short term and sudden-onset vertigo occurring frequently and not responding to medical treatment.2) Patients became asymptomatic immediately when the attacks ended.3) Hearing loss fluctuated widely but briefly at low or wide frequency ranges.4) In some cases there were associated ipsilateral facial spasms and/or trigeminal neuralgia.5) Nausea and vomiting during the vertigo attacks were less prominent than with Meniere's syndrome.6) Severe and frequent attacks were observed even, in patients with severe semicircular canal palsy.7) Vertebral angiography showed elongation and enlargement and sharp angulation of the fourth segment of the vertebral artery on the affected side.