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Neurovascular compression in painful tic convulsif
E T Fonoff1, V P Araújo, Y S A de Oliveira
1Division of Functional Neurosurgery, Department of Neurology of School of Medicine of University of São Paulo, São Paulo, SP, Brazil. fonoffet@usp.br
Acta Neurochirurgica
|April 28, 2009
Summary
A 67-year-old woman experienced hemifacial spasm and neuropathic pain due to vertebro-basilar artery compression of cranial nerves. This case highlights the complex relationship between vascular compression and neurological symptoms.
Area of Science:
- Neurology
- Neuroscience
- Vascular Neurology
Background:
- Hemifacial spasm and neuropathic pain can arise from neurovascular compression.
- Cranial nerve involvement may present with diverse neurological deficits.
Observation:
- A 67-year-old woman presented with left hemifacial spasm, progressing to sharp, shock-like facial pain (V1/V2 territories) and reduced left-sided nausea reflex.
- Imaging revealed a giant, tortuous vertebro-basilar artery compressing cranial nerves V, VII, VIII, IX, and X.
Findings:
- The study details a rare case of extensive cranial nerve compression by a vertebro-basilar arterial complex.
- The patient exhibited symptoms of hemifacial spasm, trigeminal neuralgia, and autonomic dysfunction.
Implications:
- This case underscores the potential for significant neurological dysfunction from vertebro-basilar artery compression.
- It illustrates the nonlinear relationship between vascular compression and symptom manifestation, emphasizing the need for comprehensive neurovascular evaluation.
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