PMC5420020_01
Continuous monitor lead electrocardiogram showing asystole followed by bradycardia and junctional escape during neuralgic pain.
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Both noninvasive and invasive monitoring showed a simultaneous decrease in the heart rate and blood pressure with the onset of pain (Figure 1).
A: MRI axial 3D T2 SPACE: the arrow points to the posterior inferior cerebellar artery that cross the glossopharyngeal nerve closely. B: MRI axial 3D TOF: the hyperintense line next to the brainstem is the thick posterior inferior cerebellar artery. 3D = 3-dimensional; MRI = magnetic resonance imaging; T2 SPACE = Sampling Perfection with Application optimized Contrasts using different flip angle Evolution; TOF =Time of Flight.
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An additional magnetic resonance image addressing the anatomical relationship between cranial nerves and vessels demonstrated neurovascular compression of nerve IX by a thick posterior inferior cerebellar artery (PICA). (Figures 2A and 2B).
Continuous monitor lead electrocardiogram showing the effect of the pacemaker during an attack.
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This resulted in a reduction of the length of syncope (Figure 3).