Department of Neurosurgery, Nara Medical University, Nara, Japan.
Neurosurgery. 2011 Sep;69(3):E768-71; discussion E771-2. doi: 10.1227/NEU.0b013e318218db06.
Hemifacial spasm is usually caused by compression of the facial nerve at the root exit zone (REZ), whereas fusiform aneurysmal compression is extremely rare. The authors describe symptomatic hemifacial spasm caused by a contralateral fusiform aneurysm of the vertebral artery (VA) that was treated by endovascular coil embolization.
A 55-year-old woman developed left hemifacial spasm that had gradually worsened over a period of 2 years before admission to our hospital. Cerebral angiography showed an elongated right VA fusiform aneurysm near the VA union that inclined toward the left side. The cause of the facial spasm was considered to be compression of the left facial nerve REZ by the aneurysm. Endovascular parent artery embolization including the aneurysm was performed. The hemifacial spasm disappeared within 3 months.
Hemifacial spasm caused by contralateral VA fusiform aneurysm can be treated by intravascular parent artery occlusion with coil embolization.
面肌痉挛通常由面神经根部出口区（REZ）受压引起，而梭形动脉瘤压迫极为罕见。作者描述了一例由椎动脉（VA）对侧梭形动脉瘤引起的症状性面肌痉挛，该患者通过血管内线圈栓塞治疗。
一名 55 岁女性出现左侧面肌痉挛，在入住我院前 2 年内逐渐加重。脑血管造影显示右侧 VA 近 VA 汇合处有一个细长的梭形动脉瘤，向左侧倾斜。面肌痉挛的原因被认为是动脉瘤对面神经左侧 REZ 的压迫。进行了包括动脉瘤在内的血管内母动脉栓塞。3 个月内面肌痉挛消失。
血管内母动脉闭塞线圈栓塞可治疗对侧 VA 梭形动脉瘤引起的面肌痉挛。
