Microvascular Decompression for Hemifacial Spasm Associated with Vertebrobasilar Artery

Kim, Joo Pyung; Park, Bong Jin; Choi, Seok Keun; Rhee, Bong Arm; Lim, Young Jin

doi:10.3340/jkns.2008.44.3.131

Cited by 33 publications

(17 citation statements)

References 27 publications

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“…In HFS caused by VA compression, it is reportedly difficult to reposition the vessels safely and effectively during MVD when the VA is large and ectatic and sometimes associated with branches. 4 Some cases of VA ectasia are thought to be caused by atherosclerosis with coexisting hypertension, diabetes, or other risk factors. 4 In the present patient, the compressing VA was ectatic not only because of pre-existing borderline hypertension, but also hemodynamic stress due to increased blood flow to the anterior circulation.…”

Section: Discussionmentioning

confidence: 99%

“…4 Some cases of VA ectasia are thought to be caused by atherosclerosis with coexisting hypertension, diabetes, or other risk factors. 4 In the present patient, the compressing VA was ectatic not only because of pre-existing borderline hypertension, but also hemodynamic stress due to increased blood flow to the anterior circulation. Therefore, when decompressing an artery in this situation, it is important not to interfere with the blood flow in this vessel.…”

Section: Discussionmentioning

confidence: 99%

“…However, the MVD procedure can be difficult in patients who have extensive tortuosity of the vertebral or basilar artery or arterial compression due to an anatomically complex congenital anomaly. [3][4][5][6] Here we report a patient with HFS that was caused by compression of the vertebral artery (VA) resulting from congenital agenesis of the internal carotid artery (ICA). The VA was large and tortuous, because it supplied not only the posterior circulation but also the middle cerebral artery area of the left cerebral hemisphere.…”

Section: Introductionmentioning

confidence: 99%

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Successful Treatment of Hemifacial Spasm Caused by an Ectatic Vertebral Artery Accompanying Agenesis of the Carotid Artery

Takeda

Ookawara

Fushihara

et al. 2016

Surg J

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We report the successful treatment of a patient with hemifacial spasm due to a tortuous vertebral artery that appeared to have developed to compensate for agenesis of the ipsilateral carotid artery. The 51-year-old man presented with a 1-year history of progressive left hemifacial spasm. His medical history was otherwise unremarkable except for untreated mild hypertension. Magnetic resonance angiography and bone window computed tomography demonstrated congenital agenesis of the left carotid artery and compression of the root exit zone of the left facial nerve by a tortuous left vertebral artery (VA). Microvascular decompression was performed via a left suboccipital craniotomy, and the offending vessel was identified using endoscopy. The vertebral artery was successfully transposed using polytetrafluoroethylene (PTFE) tape and a PTFE ball (Bard PTFE felt, Tempe, Arizona). This is the first report of a patient with hemifacial spasm caused by an ectatic VA associated with agenesis of the ipsilateral carotid artery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Successful Treatment of Hemifacial Spasm Caused by an Ectatic Vertebral Artery Accompanying Agenesis of the Carotid Artery

Takeda

Ookawara

Fushihara

et al. 2016

Surg J

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“…Occasionally, a tortuous vertebral artery (VA) may be involved. 12 However, the small arterioles that branch from the above arteries have often been ignored. After experience with more than 1000 MVD for patients with HFS, we realized that failure to identify involved arteriole(s) may be one of the reasons for an unsuccessful MVD.…”

Section: Introductionmentioning

confidence: 99%

Role of arterioles in management of microvascular decompression in patients with hemifacial spasm

Zhu

Zhong

et al. 2012

Journal of Clinical Neuroscience

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“…Causes of HFS include blood vessel, tumor, and bony abnormality15). Since Campbell and Keedy2) first described vascular arterial compression of the facial nerve among patients with HFS.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Microvascular Decompression for Hemifacial Spasm Caused by Vertebrobasilar Dolichoectasia

Kang

Chung

et al. 2012

J Korean Neurosurg Soc

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ObjectiveHemifacial spasm (HFS) caused by vertebrobasilar dolichoectasia (VBD) is very rare, and in theses cases, it is difficult to decompress the nerve from its vascular compression. The objective of this study was to investigate the outcome of microvascular decompression (MVD) for HFS caused by VBD.MethodsThere were 10 patients of HFS caused by VBD at our hospital between September 1978 and September 2008. We evaluated magnetic resonance angiography (MRA) and time of flight magnetic resonance imaginge (TOF MRI) findings using the criteria for VBD. We compared the clinical outcomes of MVD for the 10 patients with VBD with the overall outcomes of the total 2058 MVDs performed for HFS.ResultsThe results of MVD for HFS caused by VBD were successful in 90.9% of cases. The postoperative complication rate in VBD was 45.5%. Offending vessels in patients with VBD were identified visually during surgery. Adverse effects after MVD were found in 4 patients. We found that the diameter of VBD was significantly greater in patients with complications than in those with no complications (p=0.028).ConclusionOur data shows that MVD may be a good treatment modality for HFS caused by VBD but care must be taken to avoid adverse effects from the procedure. It is important to detach the dolichoectatic artery from its surrounding structures sufficiently to allow it to be easily movable. In addition, attempts should be made to lessen the retraction of the cerebellum during release of the dolichoectatic artery.

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Microvascular Decompression for Hemifacial Spasm Associated with Vertebrobasilar Artery

Cited by 33 publications

References 27 publications

Successful Treatment of Hemifacial Spasm Caused by an Ectatic Vertebral Artery Accompanying Agenesis of the Carotid Artery

Successful Treatment of Hemifacial Spasm Caused by an Ectatic Vertebral Artery Accompanying Agenesis of the Carotid Artery

Role of arterioles in management of microvascular decompression in patients with hemifacial spasm

The Effect of Microvascular Decompression for Hemifacial Spasm Caused by Vertebrobasilar Dolichoectasia

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