He Pengchen, Li Zongping, Jiang Han
Department of Neurosurgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan, China.
Department of Rehabilitation Therapy, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan, China.
Front Neurol. 2023 Jul 25;14:1203751. doi: 10.3389/fneur.2023.1203751. eCollection 2023.
Hemifacial spasm due to fusiform aneurysm of the vertebral artery is extremely rare. The lateral spread response (LSR) is routinely used to monitor hemifacial spasms during microvascular decompression to predict the degree of postoperative remission of hemifacial spasm. We report a case of hemifacial spasm caused by an unruptured fusiform vertebral aneurysm treated with intravascular intervention and monitoring of LSR. A 59-year-old man was admitted to the hospital with a left facial spasm that gradually worsened for 1 year. Preoperative cerebrovascular angiography indicated fusiform aneurysms in the intracranial segment of the left vertebral artery close to the left facial nerve. The patient underwent parent artery occlusion and aneurysm embolization, and LSR was monitored intraoperatively. After intraoperative aneurysm embolization, LSR disappeared immediately. The postoperative review of cerebrovascular angiography indicated that the parent artery and aneurysm were embolized successfully, and the patient's left facial spasm was relieved after surgery. Hemifacial spasm caused by the vertebral artery fusiform aneurysm can be safely and effectively treated by parent artery occlusion and aneurysm embolization. Meanwhile, intraoperative LSR monitoring can be used to predict postoperative efficacy.
椎动脉梭形动脉瘤所致的半面痉挛极为罕见。微血管减压术中常规使用侧方扩散反应（LSR）来监测半面痉挛，以预测半面痉挛术后缓解程度。我们报告1例未破裂的椎动脉梭形动脉瘤所致半面痉挛患者，采用血管内介入治疗并监测LSR。一名59岁男性因左侧面部痉挛逐渐加重1年入院。术前脑血管造影显示左椎动脉颅内段靠近左侧面神经处有梭形动脉瘤。患者接受了供血动脉闭塞及动脉瘤栓塞术，并在术中监测LSR。术中动脉瘤栓塞后，LSR立即消失。术后脑血管造影复查显示供血动脉和动脉瘤栓塞成功，患者术后左侧面部痉挛缓解。椎动脉梭形动脉瘤所致半面痉挛可通过供血动脉闭塞及动脉瘤栓塞术安全有效地治疗。同时，术中LSR监测可用于预测术后疗效。
