Hemifacial Spasm Due to Contralateral Aneurysmal Compression of the Facial Nerve Successfully Treated With Endovascular Coil Embolization: Case Report

Nakagawa, Ichiro; Takayama, Katsutoshi; Kurokawa, Syuhei; Wada, Takeshi; Nakagawa, Hiroyuki; Kichikawa, Kimihiko; Nakase, Hiroyuki

doi:10.1227/neu.0b013e318218db06

Cited by 20 publications

(10 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…1,11 Endovascular treatment is rarely effective for HFS when the offending arterial structure is cerebral aneurysm. [2][3][4][5][6][7] Six cases with HFS caused by VA aneurysms were treated by endovascular treatment in the literature. [2][3][4][5][6][7] Parent artery occlusion, intraaneurysmal coil embolization, and flow diverter stent were performed for four fusiform/dissecting aneurysms, one VA-PICA aneurysm, and one VA saccular aneurysm, respectively.…”

Section: Discussion Previous Reports Of Endovascular Treatment For Hfsmentioning

confidence: 99%

“…[2][3][4][5][6][7] Six cases with HFS caused by VA aneurysms were treated by endovascular treatment in the literature. [2][3][4][5][6][7] Parent artery occlusion, intraaneurysmal coil embolization, and flow diverter stent were performed for four fusiform/dissecting aneurysms, one VA-PICA aneurysm, and one VA saccular aneurysm, respectively. In these six cases, endovascular material was directly placed at the offending intracranial vascular structure, and HFS was resolved in all cases.…”

Section: Discussion Previous Reports Of Endovascular Treatment For Hfsmentioning

confidence: 99%

See 1 more Smart Citation

Computational hemodynamic analysis of the offending vertebral artery at the site of neurovascular contact in a case of hemifacial spasm associated with subclavian steal syndrome: illustrative case

Tominaga¹,

Endo

Sugiyama

et al. 2021

Journal of Neurosurgery: Case Lessons

View full text Add to dashboard Cite

BACKGROUND Hemifacial spasm (HFS) is caused by neurovascular contact along the facial nerve’s root exit zone (REZ). The authors report a rare HFS case that was associated with ipsilateral subclavian steal syndrome (SSS). OBSERVATIONS A 42-year-old man with right-sided aortic arch presented with progressing left HFS, which was associated with ipsilateral SSS due to severe stenosis of the left brachiocephalic trunk. Magnetic resonance imaging showed contact between the left REZ and vertebral artery (VA), which had shifted to the left. The authors speculated that the severe stenosis at the left brachiocephalic trunk resulted in the left VA’s deviation, which was the underlying cause of the HFS. The authors performed percutaneous angioplasty (PTA) to dilate the left brachiocephalic trunk. Ischemic symptoms of the left arm improved after PTA, but the HFS remained unchanged. A computational fluid dynamics study showed that the high wall shear stress (WSS) around the site of neurovascular contact decreased after PTA. In contrast, pressure at the point of neurovascular contact increased after PTA. LESSONS SSS is rarely associated with HFS. Endovascular treatment for SSS reduced WSS of the neurovascular contact but increased theoretical pressure of the neurovascular contact. Physical release of the neurovascular contact is the best treatment option for HFS.

show abstract

Section: Discussion Previous Reports Of Endovascular Treatment For Hfsmentioning

confidence: 99%

Section: Discussion Previous Reports Of Endovascular Treatment For Hfsmentioning

confidence: 99%

Computational hemodynamic analysis of the offending vertebral artery at the site of neurovascular contact in a case of hemifacial spasm associated with subclavian steal syndrome: illustrative case

Tominaga¹,

Endo

Sugiyama

et al. 2021

Journal of Neurosurgery: Case Lessons

View full text Add to dashboard Cite

show abstract

“…Interestingly, the spasm gradually improved in cases of embolization of a parent artery or an aneurysm without MVD. 3,15,16 In contrast, immediate disappearance of HFS has been achieved in cases of MVD. 2,4,[17][18][19] These findings suggest that hemodynamic change following embolization of the aneurysm is not sufficient for the immediate resolution of HFS.…”

Section: Discussionmentioning

confidence: 99%

“…1 However, HFS caused by fusiform aneurysm has been reported in only a few cases. [2][3][4] For the treatment of this rare condition, various factors should be considered.…”

Section: Introductionmentioning

confidence: 99%

Real-time Monitoring of the Lateral Spread Response Resulting from Serial Decompression for Hemifacial Spasm Caused by a Fusiform Aneurysm

Lee

Choi

Kim

2015

J Neurol Surg A Cent Eur Neurosurg

View full text Add to dashboard Cite

Fusiform aneurysm as a cause of hemifacial spasm (HFS) is an extremely rare condition. A 69-year-old man developed paroxysmal spasm of his left side facial muscles over a period of 5 years. Radiologic images demonstrated a left vertebral artery (VA) fusiform aneurysm compressing the root entry zone of the left facial nerve. The patient underwent serial surgical procedures for the treatment of HFS under intraoperative electromyography monitoring. Lateral spread response (LSR) did not disappear despite 5 minutes of extracranial left VA ligation and remained after cerebrospinal fluid drainage after dura opening. After interposition of the VA through Teflon felt insertion, the LSR finally disappeared. The patient became symptom free immediately after the surgery and continued as such throughout a follow-up period of 1 year. This is the first report involving real-time monitoring of the LSR changes resulting from serial procedures of decompression in an HFS caused by a fusiform aneurysm of the VA.

show abstract

“…1 Vascular compression was usually caused by the anterior inferior cerebellar artery (AICA), posterior inferior cerebellar artery, or vertebral artery. 2 Other causes of hemifacial spasms were known as posterior circulation aneurysms, 3 arteriovenous malformations, 4 and cerebellopontine angle (CPA) tumors, 5 but these cases are rarely observed. Among these cases, CPA arachnoid cyst is very rare, and we have never experienced a case.…”

mentioning

confidence: 99%

A Case of Facial Spasm Associated with Ipsilateral Cerebellopontine Angle Arachnoid Cyst

Ogawa

Hiroshima

2015

Surg J

View full text Add to dashboard Cite

The most common case of hemifacial spasm was reported to be vascular compression at the root exit zone (REZ) of the facial nerve. 1 Vascular compression was usually caused by the anterior inferior cerebellar artery (AICA), posterior inferior cerebellar artery, or vertebral artery. 2 Other causes of hemifacial spasms were known as posterior circulation aneurysms, 3 arteriovenous malformations, 4 and cerebellopontine angle (CPA) tumors, 5 but these cases are rarely observed. Among these cases, CPA arachnoid cyst is very rare, and we have never experienced a case. Herein, we report our experience on hemifacial spasm associated with CPA arachnoid cyst. Case ReportThis study was approved by the Ethics Committee of Asahikawa Medical University.A 66-year-old woman was admitted to our hospital with a chief complaint of twitching of the right facial muscle for 3 years. The spasm originated particularly in the inferior orbicularis oculi and did not extend to lower part of the face. The patient previously had Botox therapy at another hospital, but it was ineffective. Except for facial spasm, no neurologic abnormality, including hearing deficit, was observed. Preoperative T2-weighted magnetic resonance imaging demonstrated hyperintense area resembling an arachnoid cyst in the right CPA. The image also indicated that the REZ of the facial nerve was compressed by the AICA, which was displaced by the cyst (►Fig. 1).We performed cyst and microvascular decompression by a right suboccipital lateral approach. The cyst wall was clear and transparent. Upon excision of the cyst wall, we detected normal-looking cranial nerves VII and VIII. A branch of the AICA compressed the REZ of the facial nerve rostrally. The artery was separated from the REZ to completely decompress the facial nerve (►Fig. 2). To maintain the decompression, we attached the artery on tentorium cerebelli using Teflon felt and bioadhesion (blood-clotting factors). After surgery, the patient was immediately relieved of hemifacial spasm, and no neural complications such as facial paresis, hypoacusis, and dysphasia were observed. The surgical scar was also in good condition without any infections. On pathologic diagnosis, the cyst wall was revealed to be a typical arachnoid membrane.The patient was discharged 8 days after surgery in good condition. At follow-up 6 months after surgery, the patient was still symptom-free without any complications. DiscussionWe present the occurrence of hemifacial spasm and CPA arachnoid cyst in a patient who was fully treated by decompression of the cyst and microvascular structures. This case suggested that CPA arachnoid cysts can also play an important Keywords ► cerebellopontine angle arachnoid cyst ► hemifacial spasm ► microvascular decompression AbstractThe authors report a rare case of right cerebellopontine angle cyst related to hemifacial spasm. The patient was a 66-year-old woman with a 3-year history of right hemifacial spasm. The cyst was diagnosed preoperatively by T2-weighted magnetic resonance imaging, which demonstrated a ...

show abstract

Hemifacial Spasm Due to Contralateral Aneurysmal Compression of the Facial Nerve Successfully Treated With Endovascular Coil Embolization: Case Report

Abstract: Hemifacial spasm caused by contralateral VA fusiform aneurysm can be treated by intravascular parent artery occlusion with coil embolization.

Cited by 20 publications

References 19 publications

Computational hemodynamic analysis of the offending vertebral artery at the site of neurovascular contact in a case of hemifacial spasm associated with subclavian steal syndrome: illustrative case

Computational hemodynamic analysis of the offending vertebral artery at the site of neurovascular contact in a case of hemifacial spasm associated with subclavian steal syndrome: illustrative case

Real-time Monitoring of the Lateral Spread Response Resulting from Serial Decompression for Hemifacial Spasm Caused by a Fusiform Aneurysm

A Case of Facial Spasm Associated with Ipsilateral Cerebellopontine Angle Arachnoid Cyst

Contact Info

Product

Resources

About