Analysis of Causative Blood Vessels Using Heavily T2-weighted MRI in Patients with Hemifacial Spasm

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  • Kobayashi Shunsaku
    Department of Ophthalmology, Dokkyo Medical University, Koshigaya Hospital
  • Hara Yuji
    Department of Ophthalmology, Dokkyo Medical University, Koshigaya Hospital
  • Igarashi Masafumi
    Department of Radiology, Dokkyo Medical University, Koshigaya Hospital
  • Suzuki Tone
    Department of Ophthalmology, Dokkyo Medical University, Koshigaya Hospital
  • Machida Shigeki
    Department of Ophthalmology, Dokkyo Medical University, Koshigaya Hospital

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  • MRI heavy T2強調画像を用いた片側顔面痙攣の病因血管についての検討

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Abstract

Hemifacial spasms (HFSs) can be classified into primary and secondary types. A primary HFS is caused by vascular compression of the facial nerve. The arteries that are commonly implicated are the anterior inferior cerebellar artery (AICA) and posterior inferior cerebellar artery (PICA). Twenty-one patients with HFS underwent axial and coronal heavily T2-weighted MRI. We performed three-dimensional evaluation of the vascular compression and the direction of the facial nerve. We also examined the relationship between the vessel compression and clinical signs. In 91% of patients with HFS, the vessels responsible for the neurovascular compression were present in the affected side (i.e., the side showing the spasm) in the cerebellopontine angle cistern. The most frequent vessel was the AICA in the affected side in 9 cases, followed by the PICA in the affected side in 6 cases. Moreover, our results indicate that inferior compression towards the facial nerve is the most probable mechanism of primary HFS. However, MRI abnormalities were found in 40% of unaffected patients, although this was not statistically significant when compared to those in the normal subjects.

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