Possible Role of Neurointerventional Techniques in the Diagnosis of Hemifacial Spasm

Remission of neurovascular conflicts in the cerebellopontine angle in interventional neuroradiology

“…Thrombosis and shrinkage of the aneurysm sac and inhibition of the arterial pulsation caused by hemodynamic changes after embolization may relieve the mass effect. The latter hypothesis is supported by a report that insertion of a microcatheter into the offending artery results in transient improvement of HFS, probably caused by weakening of the offending vessel's pulsation 28. Similarly, one of our cases (case 3) presented with transient resolution of GPN after only DSA examination, which may be caused by hemodynamic changes resulting from slight vasospasm or thrombosis of the feeding artery.…”

Usefulness of Balloon Test Occlusion in the Diagnosis of Glossopharyngeal Neuralgia -Case Report-

“…6) However, anatomical findings of vascular compression of only the lower cranial nerves do not constitute grounds for a definitive diagnosis of GPN. Insertion of a microcatheter into the PICA has been reported to stop hemifacial spasm 16) and to exacerbate GPN. 11) In a previous patient, microcatheter insertion resulted in translocation of the involved vessel to the root entry zone of the glossopharyngeal nerve and neuralgia exacerbation.…”

“…The manipulation of microcatheters and guidewires within the cerebral arteries has been used to diagnose hemifacial spasm 16) and GPN, 11) although such manipulation in the artery compressing the nerve may induce hemifacial spasm or GPN. Neuralgia may be attributable to pulsation of the vessel, so stopping the pulsation may lead to the disappearance of the neuralgia.…”

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

“…This hypothesis is supported by a recent report that selective catheterization of the posterior inferior cerebellar artery resulted in transient improvement of HFS, probably by weakening the arterial pulsation and straightening the arterial loop that separates the artery and nerve. 13) Although the longterm results of vertebral artery coil embolization remain to be evaluated, endovascular trapping of a vertebral artery aneurysm can be used to treat HFS caused by an aneurysm instead of surgical microvascular decompression.…”