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Updated: May 5, 2026
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Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
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Pontine Microtubular Signal Intensity in Hemifacial Spasm: Association with Outcome After Microvascular Decompression
Hyun Seok Lee1, Hong Gee Roh2, Won-Jin Moon2
1Department of Neurosurgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Republic of Korea.
Life (Basel, Switzerland)
|May 4, 2026
Summary
Pontine microtubular signal intensity (MSI) is more common in hemifacial spasm (HFS) patients and indicates a higher chance of delayed recovery after microvascular decompression (MVD). However, long-term outcomes remain unaffected by MSI presence.
Area of Science:
- Neurology
- Radiology
- Neurosurgery
Background:
- Investigating pontine microtubular signal intensity (MSI), potentially dilated perivascular or perineural spaces.
- Utilizing high-resolution proton density-weighted imaging (HR-PDI) for assessment in hemifacial spasm (HFS) patients.
Purpose of the Study:
- To determine the prevalence and clinical significance of pontine MSI in HFS patients.
- To evaluate the association between MSI and outcomes following microvascular decompression (MVD).
Main Methods:
- Retrospective analysis of 438 HFS patients undergoing MVD and preoperative HR-PDI.
- Defining MSI as hyperintense lesions along the pontine facial nerve fascicles.
- Comparing outcomes based on MSI presence and laterality, with a control group of 307 subjects.
Main Results:
- MSI was more frequent in HFS patients (61.0% ipsilateral) than controls (OR, 3.78).
- Ipsilateral MSI correlated with contralateral MSI and vertebral artery compression.
- Immediate postoperative improvement after MVD was less frequent in patients with ipsilateral MSI (77.5% vs. 86.5%), independently associated with lower improvement likelihood (OR, 0.411).
Conclusions:
- Pontine MSI on HR-PDI is more prevalent in HFS patients.
- MSI is linked to reduced immediate postoperative improvement and delayed recovery after MVD.
- MSI may indicate microstructural changes and serve as a marker for delayed recovery, without affecting long-term outcomes.
