Monitoring of the lateral spread response in the endovascular treatment of a hemifacial spasm caused by an unruptured vertebral artery aneurysm

2004 ◽  
Vol 101 (5) ◽  
pp. 861-863 ◽  
Author(s):  
Hiroatsu Murakami ◽  
Tadashi Kawaguchi ◽  
Masafumi Fukuda ◽  
Yasushi Ito ◽  
Hitoshi Hasegawa ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Vertebral Artery ◽  
Hemifacial Spasm ◽  
Artery Aneurysm ◽  
Endovascular Surgery ◽  
Lateral Spread ◽  
Content Type ◽  
Lateral Spread Response ◽  
The Right ◽  
Fine Print

✓ The lateral spread response (LSR) is used in the electrophysiological diagnosis of a hemifacial spasm or for monitoring during microvascular decompression. The authors used LSRs for intraoperative monitoring during endovascular surgery in a rare case of vertebral artery (VA) aneurysm that caused intractable hemifacial spasm. A 49-year-old woman presented with a right hemifacial spasm that had persisted for 9 months. No other clinical symptom was observed. Vertebral artery angiography revealed a saccular aneurysm of the right VA. Magnetic resonance (MR) imaging demonstrated that the aneurysm was compressing the root exit zone of the right facial nerve. Endovascular treatment of the VA aneurysm was performed while monitoring the patient's LSRs. During occlusion of the VA at sites distal and proximal to the aneurysm, the LSRs temporarily disappeared and then reappeared with a higher amplitude than those measured preceding their disappearance. The hemifacial spasm alleviated gradually and disappeared completely 6 months after treatment. The LSRs changed in parallel with the improvement in the patient's hemifacial spasms and eventually disappeared. No recurrence of symptoms has been noticed as of 18 months postoperatively. This is the first report of the use of LSR monitoring during endovascular surgery for an intracranial aneurysm that causes hemifacial spasm. Intraoperative and postoperative changes in the LSRs provided useful information regarding the pathophysiology of hemifacial spasm.

Monitoring facial EMG responses during microvascular decompression operations for hemifacial spasm

1987 ◽  
Vol 66 (5) ◽  
pp. 681-685 ◽  
Author(s):  
Aage R. Møller ◽  
Peter J. Jannetta
Keyword(s):  
Facial Nerve ◽  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
Lateral Spread ◽  
Emg Activity ◽  
Content Type ◽  
Facial Emg ◽  
Lateral Spread Response ◽  
Fine Print ◽  
Stimulation Of

✓ Facial electromyographic (EMG) responses were monitored intraoperatively in 67 patients with hemifacial spasm who were operated on consecutively by microvascular decompression of the facial nerve near its exit from the brain stem. At the beginning of the operation, electrical stimulation of the temporal or the zygomatic branch of the facial nerve gave rise to a burst of EMG activity (autoexcitation) and spontaneous EMG activity (spasm) that could be recorded from the mentalis muscle in all patients. In some patients, the spontaneous activity and the autoexcitation disappeared after the dura was incised or when the arachnoid was opened, but stimulation of the temporal branch of the facial nerve caused electrically recordable activity in the mentalis muscle (lateral spread) with a latency of about 10 msec that lasted until the facial nerve was decompressed in all but one patient, in whom it disappeared when the arachnoidal membrane was opened. When the facial nerve was decompressed, this lateral spread of antidromic activity disappeared totally in 44 cases, in 16 it was much reduced, and in seven it was present at the end of the operation at about the same strength as before craniectomy. In four of these last seven patients there was still very little improvement of the spasm 2 to 6 months after the operation; these four patients underwent reoperation. In two of the remaining three patients, the spasm was absent at the 3- and 7-month follow-up examination, respectively, and one had mild spasm. Of the 16 patients in whom the lateral spread response was decreased as a result of the decompression but was still present at the end of the operation, 14 had no spasm and two underwent reoperation and had mild spasm at the last examination. Of the 44 patients in whom the lateral spread response disappeared totally, 42 were free from spasm and two had occasional mild spasm at 6 and 13 months, respectively, after the operation. Monitoring of facial EMG responses is now used routinely by the authors during operations to relieve hemifacial spasm, and is performed simultaneously with monitoring of auditory function for the purpose of preserving hearing. The usefulness of monitoring both brain-stem auditory evoked potentials recorded from electrodes placed on the scalp and compound action potentials recorded directly from the eighth cranial nerve is evaluated.

Posterior inferior to posterior inferior cerebellar artery anastomosis combined with trapping for vertebral artery aneurysm

1990 ◽  
Vol 73 (3) ◽  
pp. 462-465 ◽  
Author(s):  
James I. Ausman ◽  
Fernando G. Diaz ◽  
Sean Mullan ◽  
Randy Gehring ◽  
Balaji Sadasivan ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Aneurysm ◽  
Artery Ligation ◽  
Content Type ◽  
Cerebellar Artery ◽  
Vertebrobasilar Junction ◽  
Vertebral Aneurysm ◽  
The Right ◽  
Fine Print

✓ A case is presented in which a giant intracranial vertebral artery aneurysm gave rise to an associated ipsilateral posterior inferior cerebellar artery (PICA) from its waist. Proximal vertebral artery ligation at C-1 was achieved. The aneurysm filled from the opposite vertebrobasilar junction. Direct intracranial trapping of the right vertebral aneurysm was followed by successful anastomosis of the proximally sectioned right PICA to the adjacent left PICA in an end-to-end fashion.

Vertebrobasilar insufficiency secondary to vertebral artery occlusion from a fibrous band

1982 ◽  
Vol 56 (4) ◽  
pp. 581-583 ◽  
Author(s):  
Timothy Mapstone ◽  
Robert F. Spetzler
Keyword(s):  
Vertebral Artery ◽  
Artery Occlusion ◽  
Vertebrobasilar Insufficiency ◽  
Fibrous Band ◽  
Content Type ◽  
Vertebral Artery Occlusion ◽  
The Right ◽  
Band Crossing ◽  
Fine Print

✓ A case is described in which vertebral artery occlusion, caused by a fibrous band, occurred whenever the patient turned his head to the right side, resulting in vertigo and syncope whenever the head was turned to the right. Release of a fibrous band crossing the vertebral artery 2 cm from its origin relieved the patient's vertebral artery constriction and symptoms.

Hemodynamic analysis of associated extracranial atraumatic vertebral artery aneurysm and arteriovenous fistula

1987 ◽  
Vol 67 (6) ◽  
pp. 940-943 ◽  
Author(s):  
Bruce Rosenblum ◽  
Stephanie Rifkinson-Mann ◽  
Michael Sacher ◽  
Rosemaria Gennuso ◽  
Allen Rothman
Keyword(s):  
Vertebral Artery ◽  
Arteriovenous Fistula ◽  
Artery Aneurysm ◽  
Content Type ◽  
Av Fistula ◽  
Extracranial Vertebral Artery ◽  
Fine Print

✓ A case of atraumatic arteriovenous (AV) fistula of the extracranial vertebral artery associated with an atraumatic aneurysm of the contralateral extracranial vertebral artery is reported. The fistulous lesion was excised after distal and proximal ligation of the vessel. Subsequently, the contralateral aneurysm underwent spontaneous dissolution. Seven cases of extracranial vertebral AV fistulae associated with ipsilateral vertebral artery aneurysms (four traumatic and three as part of vascular dysplastic syndromes) have been reported previously.

Dural arteriovenous malformation in the posterior fossa associated with intracerebellar hematoma

1984 ◽  
Vol 60 (5) ◽  
pp. 1067-1069 ◽  
Author(s):  
Saburo Sakaki ◽  
Hitoshi Fujita ◽  
Kanehisa Kohno ◽  
Kenzo Matsuoka
Keyword(s):  
Arteriovenous Malformation ◽  
Vertebral Artery ◽  
Posterior Fossa ◽  
Dural Arteriovenous Malformation ◽  
Content Type ◽  
The Right ◽  
Fine Print

✓ A case of an infratentorial dural arteriovenous malformation associated with an intracerebellar hematoma is reported. This malformation was fed by meningeal branches of the right vertebral artery and was drained exclusively by pial veins in the posterior fossa.

Spinal arachnoid cyst developing after surgical treatment of a ruptured vertebral artery aneurysm: a possible complication of topical use of fibrin glue

1996 ◽  
Vol 84 (3) ◽  
pp. 526-529 ◽  
Author(s):  
Yoshio Taguchi ◽  
Rie Suzuki ◽  
Masaaki Okada ◽  
Hiroaki Sekino
Keyword(s):  
Adverse Effect ◽  
Vertebral Artery ◽  
Fibrin Glue ◽  
Arachnoid Cyst ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Artery Aneurysm ◽  
Content Type ◽  
Spinal Arachnoiditis ◽  
Spinal Arachnoid Cyst ◽  
Fine Print

✓ A case is reported of a 59-year-old man with a spinal arachnoid cyst accompanied by spinal arachnoiditis. The patient developed symptoms after treatment for a ruptured vertebral artery aneurysm, in which fibrin glue was used for reconstruction of the suboccipital bone defect. It is believed that the fibrin glue may have played a role in forming the arachnoid cyst. The authors urge the readers to keep in mind the possibility of subclinical spinal arachnoiditis in the patients with aneurysmal subarachnoid hemorrhage and suggest that care should be taken to avoid any possible adverse effect of fibrin glue.

Rotational vertebral artery occlusion from occipital bone anomaly: a rare cause of embolic stroke

2002 ◽  
Vol 97 (6) ◽  
pp. 1456-1459 ◽  
Author(s):  
Teiji Tominaga ◽  
Toshiyuki Takahashi ◽  
Hiroaki Shimizu ◽  
Takashi Yoshimoto
Keyword(s):  
Vertebral Artery ◽  
Three Dimensional ◽  
Craniovertebral Junction ◽  
Artery Occlusion ◽  
Occipital Bone ◽  
Atlantoaxial Instability ◽  
Posterior Arch ◽  
Content Type ◽  
The Right ◽  
Fine Print

✓ Vertebral artery (VA) occlusion by rotation of the head is uncommon, but can result from mechanical compression of the artery, trauma, or atlantoaxial instability. Occipital bone anomalies rarely cause rotational VA occlusion, and patients with nontraumatic intermittent occlusion of the VA usually present with compromised vertebrobasilar flow. A 34-year-old man suffered three embolic strokes in the vertebrobasilar system within 2 months. Magnetic resonance imaging demonstrated multiple infarcts in the vertebrobasilar territory. Angiography performed immediately after the third attack displayed an embolus in the right posterior cerebral artery. Radiographic and three-dimensional computerized tomography bone images exhibited an anomalous osseous process of the occipital bone projecting to the posterior arch of the atlas. Dynamic angiography indicated complete occlusion of the left VA between the osseous process and the posterior arch while the patient's head was turned to the right. Surgical decompression of the VA resulted in complete resolution of rotational occlusion of the artery. An occipital bone anomaly can cause rotational VA occlusion at the craniovertebral junction in patients who present with repeated embolic strokes resulting from injury to the arterial wall.

Congenital anastomosis between the vertebral artery and internal carotid artery in the neck

1979 ◽  
Vol 51 (5) ◽  
pp. 697-699 ◽  
Author(s):  
Dwight Parkinson ◽  
Venkatesha Reddy ◽  
R. T. Ross
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Vertebral Artery ◽  
Rare Case ◽  
Internal Carotid ◽  
Artery Aneurysm ◽  
Anterior Communicating Artery ◽  
Content Type ◽  
Anterior Communicating Artery Aneurysm ◽  
Fine Print

✓ A rare case of anastomosis between the vertebral artery and the internal carotid artery in the neck of a patient with an anterior communicating artery aneurysm is reported.

scholarly journals Endoscopic-Assisted Microvascular Decompression of Ectatic Vertebral Artery for Hemifacial Spasm: Operative Video and Technical Nuances

2019 ◽  
Vol 80 (S 03) ◽  
pp. S312-S313
Author(s):  
James K. Liu ◽  
Vincent N. Dodson
Keyword(s):  
Facial Nerve ◽  
Vertebral Artery ◽  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
Lateral Spread ◽  
Microsurgical Decompression ◽  
Root Exit Zone ◽  
Hearing Function ◽  
Endoscopic Assistance ◽  
Lateral Spread Response

In this operative video atlas manuscript, the authors demonstrate the operative nuances and surgical technique for endoscopic-assisted microvascular decompression of a large ectatic vertebral artery causing hemifacial spasm. A retrosigmoid approach was performed and a large ectatic vertebral artery was transposed away from the root exit zone of cranial nerve VII (Fig. 1). The lateral spread response disappeared, signifying adequate decompression of the facial nerve (Fig. 2). The use of endoscopic-assistance during the microsurgical decompression was very useful to confirm the origin and also the resolution of neurovascular conflict. Postoperatively, the patient experienced immediate resolution of hemifacial spasm with normal facial nerve and hearing function. Written consent was obtained from the patient to publish videos, photographs, and images from the surgery.The link to the video can be found at: https://youtu.be/RlMz44uCDCw.

scholarly journals Endovascular Treatment of Vertebral Artery Aneurysm Manifesting as Progressive Hemifacial Spasm

2005 ◽  
Vol 45 (7) ◽  
pp. 360-362 ◽  
Author(s):  
Keigo MATSUMOTO ◽  
Satoshi KIMURA ◽  
Kiyohito KAKITA
Keyword(s):  
Endovascular Treatment ◽  
Vertebral Artery ◽  
Hemifacial Spasm ◽  
Artery Aneurysm
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