Nagashima H, Orz Y, Okudera H, Kobayashi S, Ichinose Y
Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan.
J Clin Neurosci. 2001 Jan;8(1):43-5. doi: 10.1054/jocn.2000.0814.
Intracranial aneurysm is a rare cause of hemifacial spasm and most of the previously reported cases are treated with surgical microvascular decompression. Authors report a case of hemifacial spasm caused by a dissecting aneurysm located at the vertebrobasilar junction which improved after endovascular obliteration of the affected vertebral artery with coils. The patient was a 69-year-old man with 20 months' history of left hemifacial spasm. A vertebral angiogram showed an irregular dilatation of the right vertebral artery associated with aneurysmal dilatation at the vertebrobasilar junction. Endovascular obliteration of the abnormally dilated right vertebral artery proximal to the vertebrobasilar junction was performed. The hemifacial spasm gradually improved after the embolisation and disappeared 6 months later. Endovascular proximal obliteration of the vertebral artery may have changed the hemodynamic force inside the aneurysm and eliminated the vascular compression at the root exit zone of the facial nerve.
颅内动脉瘤是半面痉挛的罕见病因，先前报道的大多数病例采用外科微血管减压术治疗。作者报告一例由位于椎基底动脉交界处的夹层动脉瘤引起的半面痉挛病例，该患者在通过弹簧圈对患侧椎动脉进行血管内闭塞后病情改善。患者为一名69岁男性，有20个月的左侧半面痉挛病史。椎动脉血管造影显示右侧椎动脉不规则扩张，伴有椎基底动脉交界处的动脉瘤样扩张。对椎基底动脉交界处近端异常扩张的右侧椎动脉进行了血管内闭塞。栓塞后半面痉挛逐渐改善，并在6个月后消失。椎动脉血管内近端闭塞可能改变了动脉瘤内的血流动力学力量，并消除了面神经根部出口区的血管压迫。
