Tugend Margaret, Sekula Raymond F
J Neurosurg Case Lessons. 2024 Jan 1;7(1). doi: 10.3171/CASE23479.
Developmental venous anomaly (DVA) is a rare cause of hemifacial spasm (HFS). The treatment of HFS caused by a DVA varies in the literature and includes medication management, botulinum toxin injections, and microvascular decompression (MVD).
A 64-year-old woman presented with right-sided HFS. Preoperative magnetic resonance imaging showed a DVA in the right inferior pons, with an enlarged segment compressing the facial nerve at its root detachment point prior to drainage into the superior petrosal sinus. MVD was performed, and the facial nerve was decompressed without sacrifice of the vein. Immediately following the procedure, the patient had significantly reduced spasms. The patient became spasm-free 3 months after MVD and maintained spasm freedom for 3 months. Six months after MVD, the patient had a partial return of spasms. At 8 months, the patient continued to have reduced and intermittent spasms in the right orbicularis oculi muscle.
MVD for HFS caused by a DVA is a safe procedure and can be effective at reducing spasm frequency and severity.
发育性静脉异常（DVA）是半面痉挛（HFS）的罕见病因。文献中对于由DVA引起的HFS的治疗方法各异，包括药物治疗、肉毒杆菌毒素注射和微血管减压术（MVD）。
一名64岁女性出现右侧HFS。术前磁共振成像显示右侧脑桥下部存在DVA，在汇入岩上窦之前，有一段扩张的静脉在面神经根部附着点处压迫面神经。进行了MVD，面神经得到减压且未牺牲静脉。手术后，患者的痉挛立即明显减轻。MVD术后3个月，患者痉挛消失，并持续3个月无痉挛发作。MVD术后6个月，患者痉挛部分复发。在8个月时，患者右侧眼轮匝肌的痉挛持续减轻且呈间歇性发作。
对于由DVA引起的HFS，MVD是一种安全的手术方法，可有效降低痉挛频率和严重程度。
