Microvascular decompression for developmental venous anomaly causing hemifacial spasm: illustrative case.

Area of Science:

• Neurology
• Neurosurgery
• Vascular Malformations

Background:

• Developmental venous anomaly (DVA) is an uncommon etiology for hemifacial spasm (HFS).
• Treatment options for DVA-induced HFS include medication, botulinum toxin, and microvascular decompression (MVD).

Purpose of the Study:

• To evaluate the efficacy and safety of MVD in a patient with HFS secondary to a DVA.

Main Methods:

• A 64-year-old female with right-sided HFS underwent MVD.
• Magnetic resonance imaging revealed a DVA compressing the facial nerve root.
• The facial nerve was decompressed during MVD without sacrificing the DVA.

Main Results:

• Immediate post-MVD, the patient experienced significant spasm reduction.
• Complete spasm freedom was achieved at 3 months post-MVD.
• Partial, intermittent spasms returned by 8 months, though severity was reduced.

Conclusions:

• MVD is a safe and potentially effective treatment for HFS caused by DVA.
• MVD can significantly decrease spasm frequency and severity in these cases.
• Long-term efficacy may vary, with potential for spasm recurrence.