Microvascular decompression for hemifacial spasm associated with the vertebral artery

• Published in: Neurosurgical review 2013-04, Vol.36 (2), p.303-309
• Main Authors: Mikami, Takeshi, Minamida, Yoshihiro, Akiyama, Yukinori, Wanibuchi, Masahiko, Sugino, Toshiya, Houkin, Kiyohiro, Mikuni, Nobuhiro
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Decompression, Surgical - methods; Facial Nerve - pathology; Facial Nerve - surgery; Female; Hemifacial Spasm - etiology; Hemifacial Spasm - physiopathology; Hemifacial Spasm - surgery; Humans; Image Processing, Computer-Assisted; Magnetic Resonance Imaging; Male; Medicine; Medicine & Public Health; Middle Aged; Neurosurgery; Neurosurgical Procedures - methods; Original Article; Tomography, X-Ray Computed; Treatment Outcome; Vertebrobasilar Insufficiency - complications; Vertebrobasilar Insufficiency - physiopathology; Vertebrobasilar Insufficiency - surgery; Young Adult
• ISSN: 0344-5607; 1437-2320
• DOI: 10.1007/s10143-012-0425-y

In patients with vascular compression syndromes, the preoperative recognition of the cranial nerves and compressed vessels will contribute to improved surgical results. The aim of this study was to clarify the pathophysiology of hemifacial spasm (HFS) associated with the vertebral artery (VA) and to assess the value of preoperative imaging. Fifty-three consecutive patients with HFS underwent microvascular decompression (MVD). Of these, 18 cases of HFS were associated with the VA; this case series was compared with the remaining non-VA-associated HFS. For preoperative assessment, magnetic resonance imaging (MRI) was performed. Since January 2006, fusion imaging has been performed by combining MRI and computed tomography angiography. Of the 18 cases of VA-associated HFS, 17 (94.4 %) were on the left side; this was significantly higher than in the non-VA-associated HFS cases ( p