Neurotologists have grappled with this question for many years. The aim of the study was to determine the clinical relationship of vertigo symptoms with vascular loop compression syndrome using 3D T2WI turbo spin echo high-resolution MRI. The study included 417 subjects who had the scans for various medical reasons. Of these, 178 had vertigo and 239 had no vertigo. The types of loops were classified as follows type 1: vascular loop at the CPA level, type 2: vascular loop proximal to the IAC and type 3: vascular loop distal to the IAC. These were subdivided to type A: contact with the vestibulocochlear nerve (VCN), and type B: indentation to the VCN. In the whole group, type 1 (right 37.9%, left 38.4%) and type A (right 61.4%, left 61.2%) loops were the most common.
Overall, loops were present in over 60% of all subjects. Of note, irrespective of type of loop, there was no difference between the vertigo and no vertigo groups. There was also no correlation between the presence of vascular loop and aural symptoms.
This is a large study, the findings of which confirm the view of many neurotologists. The debate continues.