Choi Hyuk Jai, Lee Sung Ho, Choi Seok Keun, Rhee Bong Arm
Department of Neurosurgery, School of Medicine, Kyung Hee University, Seoul, Korea.
J Korean Neurosurg Soc. 2012 Jan;51(1):59-61. doi: 10.3340/jkns.2012.51.1.59. Epub 2012 Jan 31.
Although the mechanism of hemifacial spasm (HFS) is not yet well established, vascular compression of the facial nerve root exit zone and hyperexcitability of the facial nucleus have been suggested. We report a case of HFS in the setting of coinciding intracranial hemorrhage (ICH) of the pons and proximal ligation of the contralateral vertebral artery (VA) for the treatment of a fusiform aneurysm of the distal VA and discuss the possible etiologies of HFS in this patient. A 51-year-old male with an ICH of the pons was admitted to our hospital. Neuroimaging studies revealed an incidental fusiform aneurysm of the right VA distal to the origin of the posterior inferior cerebellar artery. Eight months after proximal ligation of the VA the patient presented with intermittent spasm of the left side of his face. Pre- and post-ligation magnetic resonance angiography revealed an enlarged diameter of the VA. The spasm completely disappeared after microvascular decompression.
尽管半面痉挛（HFS）的发病机制尚未完全明确，但有研究提示面神经根部出脑干区的血管压迫以及面神经核的兴奋性增高可能与之相关。本文报道了1例桥脑出血伴对侧椎动脉（VA）近端结扎治疗VA远端梭形动脉瘤过程中出现HFS的病例，并探讨该患者HFS可能的病因。1例51岁男性因桥脑出血入住我院。神经影像学检查发现右侧VA小脑后下动脉起始部远端存在一个偶然发现的梭形动脉瘤。VA近端结扎8个月后，患者出现左侧面部间歇性痉挛。结扎前后的磁共振血管造影显示VA直径增大。微血管减压术后痉挛完全消失。
