Department of Neurosurgery, Second Affiliated Hospital of Xi'an Jiaotong University, No.157 West Fifth Road, Xi'an, 710004, China.
Department of Radiology, Second Affiliated Hospital of Xi'an Jiaotong University, No.157 West Fifth Road, Xi'an, 710004, China.
Surg Radiol Anat. 2021 Feb;43(2):291-299. doi: 10.1007/s00276-020-02603-7. Epub 2020 Nov 1.
There exist different opinions on whether the anatomical laterality of vertebral artery (VA) is related to the unilateral onset of hemifacial spasm (HFS). In this study, we intended to qualitatively explore the potential correlation between the anatomical deviations of VA and the clinical characteristics of HFS.
Two hundred and forty patients who underwent microvascular decompression for HFS between January 2018 and December 2019 were recruited. Clinical data including medical records and preoperative MRI images were retrospectively reviewed. A score system was specially designed for VAs to illustrate their distribution, and a score-weighted cross-sectional area of VA was proposed to represent the relative thickness of VA on each side. Then, the anatomical deviations of VA were comparatively analyzed between the symptomatic side and asymptomatic side and between VA-involved cases and non-VA-involved cases.
The score and weighted cross-sectional area (WCSA) of VA in symptomatic side were significantly greater than those in asymptomatic side (P = 0.000, P = 0.000). And in symptomatic side, the score and WCSA of VA in VA-involved cases were significantly greater than those in non-VA-involved cases (P = 0.000). Moreover, with higher score (P = 0.000) and greater WCSA (P = 0.001) on the left side, the VA-involved cases showed a preference (74%) of left HFS.
In HFS, the symptomatic side tends to have an ipsilaterally deviated and relatively larger VA, especially in VA-involved cases. And it is the VA-involved cases that are prone to have a prevalence of left HFS, but not the non-VA-involved cases.
椎动脉（VA）解剖侧位是否与面肌痉挛（HFS）单侧发病有关存在不同意见。本研究旨在定性探讨 VA 解剖偏侧性与 HFS 临床特征之间的潜在相关性。
回顾性分析 2018 年 1 月至 2019 年 12 月期间因 HFS 接受微血管减压术的 240 例患者的临床资料，包括病历和术前 MRI 图像。专门设计了一个 VA 评分系统来描述其分布，并提出了 VA 的加权截面积来代表每侧 VA 的相对厚度。然后，比较分析 VA 在症状侧与无症状侧、VA 受累病例与非 VA 受累病例之间的解剖偏侧性。
症状侧 VA 的评分和加权截面积（WCSA）明显大于无症状侧（P=0.000，P=0.000）。并且在症状侧，VA 受累病例的 VA 评分和 WCSA 明显大于非 VA 受累病例（P=0.000）。此外，左侧 VA 评分越高（P=0.000）和 WCSA 越大（P=0.001），VA 受累病例更倾向于发生左侧 HFS（74%）。
在 HFS 中，症状侧往往存在同侧偏曲且相对较大的 VA，尤其是在 VA 受累病例中。并且是 VA 受累病例更倾向于发生左侧 HFS，而非非 VA 受累病例。
