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The average age of hemifacial spasm (HFS) onset is mostly between the fifth and sixth decades of life, with a relatively low incidence in younger age groups. The objective of this study was to analyze the characteristics and clinical outcomes of young-onset hemifacial spasm (YOHFS).Methods: Between April 1997 and March 2021, 151 HFS patients aged 30 years or younger at the time of microvascular decompression (MVD) were selected. We analyzed their epidemiological characteristics, intraoperative findings, improvements, and postoperative complications by reviewing medical records.Results: This study included 151 patients who underwent MVD. The average age of the patients was 26 years. The mean symptom duration was 36.5 months. The male-to-female sex ratio was 1:1.5. The most common offending vessel was the anterior inferior cerebellar artery, and the most common compression type was the arachnoid type. Improvements in spasm after MVD were seen in 96.7% of patients. No permanent facial palsy was noted after MVD. Changes in brainstem auditory-evoked potentials were recorded in 11 patients; however, no permanent hearing loss was observed. Conclusion:The characteristics and clinical outcomes of YOHFS in this study were similar to those of patients with HFS in the general population. Based on the clinical outcomes, MVD for YOHFS is effective and safe. Therefore, MVD should be considered in patients with YOHFS.

Spinal cord hemangioblastoma (HBL) is a highly vascularized tumor that occurs sporadically or in relation to von Hippel-Lindau disease. Sporadic-type HBLs in the spinal cord usually present as single lesions that are potentially curable by complete surgical resection, with a low rate of recurrence. We report a case of a totally excised sporadic-type spinal cord HBL with multiple recurrences observed 10 years after surgery. Long-term follow-up may be necessary for spinal cord HBL, even in cases of complete resection.