Endovascular Treatment of Vertebral Artery Aneurysm Manifesting as Progressive Hemifacial Spasm-Case Report-

Matsumoto, Keigo; Kimura, Satoshi; Kakita, Kiyohito

doi:10.2176/nmc.45.360

Cited by 16 publications

(6 citation statements)

References 14 publications

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“…In the recent literature, endovascular treatment has become dominant, which was performed in 11 cases. [3][4][5][6][7][8][9][10][11][12][13] Among them, seven cases were treated with parent artery occlusion, two with intra-aneurysmal coil embolization, one with a flow diverter, and one with stenting. Nine patients improved after endovascular treatment; however, one patient had a recurrence and another had no improvement.…”

Section: Results Of the Literature Reviewmentioning

confidence: 99%

Hemifacial spasm associated with posterior inferior cerebellar artery aneurysm: illustrative case

Inoue

Endo

Kanoke

et al. 2023

Journal of Neurosurgery: Case Lessons

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BACKGROUND Hemifacial spasms (HFSs) complicated by intracranial aneurysms are rare. Recently, endovascular treatment has been widely used for this disease entity and can allow the cessation of intracranial aneurysm arterial pulsation, leading to recovery from the HFS. Here, the authors present a case of HFS associated with an ipsilateral posterior inferior cerebellar artery (PICA) aneurysm successfully treated with open surgery. OBSERVATIONS A 68-year-old woman was annually followed-up for an incidentally found right PICA aneurysm. Over 3 years, the PICA aneurysm gradually increased in size, which eventually led to right HFS. An axial fast spoiled gradient-recalled echo sequence with gadolinium enhancement showed the PICA aneurysm compressing the root exit zone (REZ), which was attributed as the cause of the HFS. However, a fusion image of the three-dimensional T1-weighted fast spin-echo sequence and magnetic resonance angiogram clearly showed a direct contact between the REZ and the anterior inferior cerebellar artery (AICA), which was located at the apex of the PICA aneurysm. Intraoperatively, the AICA was found compressing the REZ; hence, microvascular decompression with aneurysmal clipping was performed. The HFS resolved immediately after surgery. LESSONS In cases of HFS associated with an ipsilateral intracranial aneurysm, a detailed neuroradiological assessment to identify the responsible lesion is important to use the most optimal treatment of choice.

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Section: Results Of the Literature Reviewmentioning

confidence: 99%

Hemifacial spasm associated with posterior inferior cerebellar artery aneurysm: illustrative case

Inoue

Endo

Kanoke

et al. 2023

Journal of Neurosurgery: Case Lessons

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“…Although most of the HFS results from NVC, there are secondary causative etiologies, such as a tumor in the posterior fossa, posterior circulation aneurysms, and vascular malformations, accounting for 0.3 to 2.5% of cases. 1 13 14 15 16 17 Among the secondary etiologies, the incidence of posterior circulation aneurysms as a major cause of HFS is much rarer with a rate of occurrence of 0.08 to 0.44%, 18 which has been reported sporadically in the form of case reports 18 19 20 21 22 23 24 25 26 27 or a few cases within large case series. 28 29 VA dissection, which is the most probable etiology of fusiform aneurysms, has been reported scarcely.…”

Section: Discussionmentioning

confidence: 99%

Treatment for Hemifacial Spasm Associated with a Dissecting Vertebral Artery Aneurysm Requiring Microvascular Decompression in Addition to Endovascular Trapping: A Case Report with Literature Review

Lee

Shin

et al. 2021

J Neurol Surg A Cent Eur Neurosurg

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Background The treatment protocol for hemifacial spasm (HFS) associated with dissecting vertebral artery aneurysm (DVAA) has not been established. Case Description A-42-year-old man with left HFS underwent endovascular trapping for a DVAA that was identified on brain imaging. Although the dissecting segment was treated successfully, the HFS persisted for 3 months, and subsequently microvascular decompression (MVD) was needed. The posteroinferior cerebellar artery (PICA) was found to be interposed between the root exit zone of the facial nerve and DVAA during surgery. After pulling out the PICA, the HFS ceased immediately. Conclusion HFS associated with DVAA should be considered carefully before formulating a treatment strategy. Moreover, the cause of pulsatile compression may not be visible on brain imaging, and MVD surgery may be indicated in such cases.

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“…1,2) For treatment of this type of HFS, clipping, endovascular treatment, and MVD have been reported. [3][4][5][6][7][8] However, many of these aneurysms were dissecting or fusiform aneurysms. Then, most of the endovascular treatments were parent artery occlusion.…”

Section: Discussionmentioning

confidence: 99%

Coil Embolization of VA-PICA Aneurysm Presenting with Hemifacial Spasm with Assistance of Abnormal Muscle Response Monitoring

Arisawa

Ochi

Gotō

et al. 2020

NOUSHINKEI KEKKANNAI TIRYOU

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We report a rare case of symptomatic vertebral and posterior inferior cerebellar arteries (VA-PICA) aneurysmcaused ipsilateral hemifacial spasm (HFS) for which coil embolization of the aneurysm with the assistance of abnormal muscle response (AMR) monitoring was effective. Case Presentation: A 62-year-old woman presented with left HFS. Magnetic resonance imaging showed a saccular aneurysm of the left VA-PICA which compressed the seventh cranial nerve at its root exit zone (REZ). Stent-assisted coil embolization resulted in intraoperative disappearance of AMR in the intraoperative electrophysiological study and HFS was relieved temporally. One month after endovascular surgery, HFS slightly occurred again with the reappearance of the AMR, although there was no recurrence of aneurysm. Thereafter, the frequency of her HFS markedly decreased to once per several days 1 year after the coiling. Conclusion: Although complete disappearance of symptoms was not obtained, it was suggested that coil embolization is one of the therapeutic options for HFS which is caused by aneurysmal compression of REZ and intraoperative AMR is useful for identification of responsible lesions and determination of therapeutic effects. Keywords▶ hemifacial spasm, aneurysm, coil embolization, abnormal muscle response with assistance of abnormal muscle response (AMR) monitoring and showed the marked improvement in symptoms. Case Presentation A 62-year-old woman presented with HFS in her left eyelid, which appeared 3 years ago and progressively aggravated over the last 6 months to be persistent during the daytime. MRI revealed a left VA-PICA aneurysm, which was in the posterior upper direction, located near REZ of the facial nerve. Then we considered the cause of HFS was the aneurysm. Neurological findings: Her general condition was good and she had no neurological abnormality except for continuous HFS of the left eyelid which did not expand to the orbicularis oris muscle or platysma. Imaging findings: Computed tomography angiography (CTA) revealed that the left vertebral artery (VA) was tortuous and a saccular aneurysm of the left VA-PICA junction, projecting toward the posterior upper direction (Fig. 1A-1C). The aneurysm had a wide neck and its neck slightly rode on the posterior inferior cerebellar artery This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives International License.

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Endovascular Treatment of Vertebral Artery Aneurysm Manifesting as Progressive Hemifacial Spasm-Case Report-

Cited by 16 publications

References 14 publications

Hemifacial spasm associated with posterior inferior cerebellar artery aneurysm: illustrative case

Hemifacial spasm associated with posterior inferior cerebellar artery aneurysm: illustrative case

Treatment for Hemifacial Spasm Associated with a Dissecting Vertebral Artery Aneurysm Requiring Microvascular Decompression in Addition to Endovascular Trapping: A Case Report with Literature Review

Coil Embolization of VA-PICA Aneurysm Presenting with Hemifacial Spasm with Assistance of Abnormal Muscle Response Monitoring

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