Trigeminal neuralgia and hemifacial spasm caused by a tortuous vertebrobasilar system.

The case of a 66-year-old woman who developed both trigeminal neuralgia and hemifacial spasm caused by a tortuous vertebrobasilar system is reported. Vertebral angiography showed a dilated and elongated basilar artery overlying the porus acusticus of the internal auditory canal. Double-contrast computed tomography scanning was very useful in evaluating this abnormality. Vascular decompression was performed by using a fenestration clip.