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Hemifacial spasm caused by a contralateral vertebral artery: case report
Y A Grigoryan1, M Z Goncharov, V V Lazebny
1Department of Neurosurgery, Russian Medical Academy of Postgraduate Education, Botkin Hospital, Moscow.
Surgical Neurology
|June 30, 2000
Summary
A rare cause of hemifacial spasm, compression of the facial nerve by a contralateral vertebral artery, was successfully treated. Surgical decompression relieved symptoms, demonstrating an effective treatment for this unusual condition.
Area of Science:
- Neurosurgery
- Vascular Neurology
Background:
- Hemifacial spasm typically results from ipsilateral blood vessel compression of the facial nerve.
- Compression by a contralateral tortuous vertebral artery is an exceptionally rare etiology.
Observation:
- A 68-year-old woman presented with left-sided hemifacial spasm.
- Magnetic resonance imaging revealed compression of the left facial nerve by a tortuous vertebrobasilar artery.
- Surgical exploration confirmed compression at the facial nerve root exit zone by the right vertebral artery.
Findings:
- Surgical decompression involved repositioning the vertebrobasilar artery and interposing a muscle implant.
- The patient experienced complete resolution of hemifacial spasm.
- Symptom relief was sustained for 27 months post-surgery.
Implications:
- Contralateral vertebral artery compression is a potential cause of hemifacial spasm.
- Surgical techniques like the sling method or implant interposition are effective for managing vessel compression.
- This case highlights the importance of considering rare vascular compressions in hemifacial spasm etiology.