Wide distribution of central myelin segment along the facial nerve might explain hemifacial spasm with distal nerve compression

2020 ◽  
Author(s):  
Kei Nomura ◽  
Hiroshi Ryu ◽  
Koji Ohno ◽  
Kohji Sato
Keyword(s):  
Facial Nerve ◽  
Hemifacial Spasm ◽  
Wide Distribution ◽  
Nerve Compression ◽  
Central Myelin ◽  
Distal Nerve

Macrovascular Decompression of Facial Nerve With Anteromedial Transposition of a Dolichoectatic Vertebral Artery: 3-Dimensional Operative Video

2018 ◽  
Vol 16 (1) ◽  
pp. E4-E4
Author(s):  
Halima Tabani ◽  
Sonia Yousef ◽  
Jan-Karl Burkhardt ◽  
Sirin Gandhi ◽  
Arnau Benet ◽  
...  
Keyword(s):  
Trigeminal Neuralgia ◽  
Facial Nerve ◽  
Hemifacial Spasm ◽  
Cranial Nerve ◽  
Nerve Compression ◽  
Large Artery ◽  
Nerve Compression Syndromes ◽  
Vertebrobasilar Artery ◽  
Patient Consent ◽  
Compression Syndromes

Abstract Most cranial nerve compression syndromes (ie, trigeminal neuralgia and hemifacial spasm) are caused by small arteries impinging on a nerve and are relieved by microvascular decompression. Rarely, cranial nerve compression syndromes can be caused by large artery impingement and can be relieved by macrovascular decompression. When present, this compression often occurs in association with degenerative atherosclerosis in the vertebral arteries (VA) and basilar artery. Conservative treatment is recommended for mild forms, but surgical transposition of the VA away from the root entry zone (REZ) can be considered. This video demonstrates macrovascular decompression of a dolichoectatic VA in a 74-yr-old female with refractory left hemifacial spasm. After obtaining IRB approval, patient consent was sought for the procedure. With the patient in three-quarter-prone position, a far-lateral craniotomy was performed. The dentate ligament was cut to free the VA, and the suprahypoglossal portion of the vagoaccessory triangle was widened. VA compressed the REZ of the facial nerve, but was mobilized anteromedially off the REZ. A muslin sling was wrapped around the VA and its tail brought down to the clival dura, which was punctured with a 19-gauge needle and enlarged with a dissector. The sling was pulled anteromedially to this puncture site and secured to the dura with an aneurysm clip, relieving the REZ of all compression. The patient tolerated the procedure with mild, transient hoarseness and her hemifacial spasm resolved completely. This case demonstrates the macrovascular decompression technique with anteromedial transposition of the vertebrobasilar artery, which can also be used for trigeminal neuralgia.

Chiari Type I Malformation Presenting as Hemifacial Spasm: Case Report

Neurosurgery ◽  
2005 ◽  
Vol 57 (2) ◽  
pp. E371-E371 ◽  
Author(s):  
Mustafa Efkan Colpan ◽  
Zeki Sekerci
Keyword(s):  
Facial Nerve ◽  
Posterior Fossa ◽  
Hemifacial Spasm ◽  
Chiari I Malformation ◽  
Posterior Fossa Decompression ◽  
Type I ◽  
Chiari Type I Malformation ◽  
Downward Displacement ◽  
Facial Spasm ◽  
Chiari I

ABSTRACT OBJECTIVE AND IMPORTANCE: We report on a patient with a Chiari I malformation presenting with right hemifacial spasm. Clinicians should consider the downward displacement of the hindbrain as a rare cause of hemifacial spasm in Chiari I malformation. CLINICAL PRESENTATION: An 18-year-old man was admitted with right hemifacial spasm. The results of the neurological examination were normal except for the facial spasm. Magnetic resonance imaging demonstrated a Chiari I malformation without syringomyelia. After surgery, the hemifacial spasm completely resolved. INTERVENTION: Posterior fossa decompression, C1 laminectomy, and duraplasty were performed. CONCLUSION: The hemifacial spasm could be attributed to compression and/or traction of the facial nerve because of downward displacement of the hindbrain in Chiari I malformation. Compression and/or traction might create irritation of the facial nerve that causes hemifacial spasm. Resolution of the hemifacial spasm after posterior fossa decompression could explain the facial nerve irritation in Chiari I malformation. Clinicians should consider Chiari malformation as a cause of hemifacial spasm and posterior fossa decompression as a potential treatment.

scholarly journals Fully Endoscopic Vascular Decompression of the Facial Nerve for Hemifacial Spasm

Skull Base ◽  
2001 ◽  
Vol 11 (03) ◽  
pp. 189-198 ◽  
Author(s):  
Joseph B. Eby ◽  
Sung Tae Cha ◽  
Hrayr K. Shahinian
Keyword(s):  
Facial Nerve ◽  
Hemifacial Spasm ◽  
Vascular Decompression

scholarly journals Hemi facial Spasm Resulting from Facial Nerve Compression Near the Internal Acoustic Meatus —Case Report—

1997 ◽  
Vol 37 (10) ◽  
pp. 771-774 ◽  
Author(s):  
Masafumi FUKUDA ◽  
Shigeki KAMEYAMA ◽  
Yoshiho HONDA ◽  
Ryuichi TANAKA
Keyword(s):  
Case Report ◽  
Facial Nerve ◽  
Nerve Compression ◽  
Internal Acoustic Meatus ◽  
Facial Spasm

scholarly journals Retrosigmoid Craniotomy for the Removal of Left Sided Tentorial and Posterior Fossa Meningioma Combined with Microvascular Decompression for Hemifacial Spasm

2018 ◽  
Vol 80 (S 03) ◽  
pp. S294-S295
Author(s):  
Yu-Wen Cheng ◽  
Chun-Yu Cheng ◽  
Zeeshan Qazi ◽  
Laligam N. Sekhar
Keyword(s):  
Facial Nerve ◽  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
Preoperative Imaging ◽  
Superior Cerebellar Artery ◽  
Anterior Inferior Cerebellar Artery ◽  
Root Exit Zone ◽  
Tentorial Meningioma ◽  
Cerebellar Artery ◽  
The Right

This 68-year-old woman presented with repeated episodes of bilateral hemifacial spasm with headache for 5 years and with recent progression of left sided symptoms. Preoperative imaging showed a left sided tentorial meningioma with brain stem and cerebellar compression. Left facial nerve was compressed by the vertebral artery (VA) and the right facial nerve by the anterior inferior cerebellar artery (AICA). This patient underwent left side retrosigmoid craniotomy and mastoidectomy. The cisterna magna was drained to relax the brain. The tumor was very firm, attached to the tentorium and had medial and lateral lobules. The superior cerebellar artery was adherent to the lateral lobule of the tumor and dissected away. The tumor was detached from its tentorial base; we first removed the lateral lobule. Following this, the medial lobule was also completely dissected and removed. The root exit zone of cranial nerve (CN) VII was dissected and exposed. The compression was caused both by a prominent VA and AICA. Initially, the several pieces of Teflon felt were placed for the decompression. Then vertebropexy was performed by using 8–0 nylon suture placed through the VA media to the clival dura. A further piece of Teflon felt was placed between cerebellopontine angle region and AICA. Her hemifacial spasm resolved postoperatively, and she discharged home 1 week later. Postoperative imaging showed complete tumor removal and decompression of left CN VII. This video shows the complex surgery of microsurgical resection of a large tentorial meningioma and microvascular decompression with a vertebropexy procedure.The link to the video can be found at: https://youtu.be/N5aHN9CRJeM.

Surgical Treatment of Hemifacial Spasm Caused by the Compression of Internal Auditory Canal of Facial Nerve

2017 ◽  
Vol 28 (6) ◽  
pp. e564-e566 ◽  
Author(s):  
Jin Zhu ◽  
Xin Zhang ◽  
Hua Zhao ◽  
Yin-Da Tang ◽  
Ting-Ting Ying ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Facial Nerve ◽  
Hemifacial Spasm ◽  
Internal Auditory Canal
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