Hemifacial Spasm Caused by Vascular Compression of the Anterior Inferior Cerebellar Artery-Posterior Inferior Cerebellar Artery Common Trunk Anomaly at the Cisternal Portion of the Facial Nerve: A Case Report

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  • HOKAZONO Mariya
    Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University
  • SHIMOGAWA Takafumi
    Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University
  • NAKAMIZO Akira
    Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University
  • YOSHIMOTO Koji
    Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University

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<p>W report the first case of hemifacial spasm (HFS) caused by vascular compression of the anterior inferior cerebellar artery (AICA) -posterior inferior cerebellar artery (PICA) common trunk anomaly at the cisternal portion of cranial nerve VII (CN VII). A 71-year-old female with a typical right HFS was admitted to our hospital. As per her magnetic resonance (MR) imaging results, no offending arteries were noted around the CN VII root exit zone (REZ). Computed tomography angiography revealed an AICA-PICA common trunk anomaly with a dominant PICA, with the rostral branch of the AICA-PICA common trunk anomaly compressing the CN VII at the cisternal portion. The patient underwent microvascular decompression (MVD), and the HFS disappeared after surgery. The amplitude of the abnormal muscle responses (AMR) disappeared immediately after complete transposition of the offending artery. However, the patient experienced mild transient facial palsy 3 days after MVD which was eventually resolved with the administration of vitamin B12. No HFS recurrence was observed during the 1-year follow-up period. The AICA-PICA common trunk anomaly has been found to cause HFS as it compressed the CN VII at the cisternal portion, and not at the REZ. AMR monitoring might be helpful for cases where the unusual vessel particularly compresses the CN VII.</p>

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  • NMC Case Report Journal

    NMC Case Report Journal 10 (0), 253-257, 2023-12-31

    一般社団法人 日本脳神経外科学会

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