Keisuke Onoda*, Tomoyuki Naito, Junpei Kato, Tomihiro Wakamiya, Yuhei Michiwaki, Kimihiro Nakahara, Tatsuya Tanaka, Takashi Agari, Takashi Sugawara, Kazuaki Shimoji, Eiichi Suehiro, Hiroshi Itokawa and Akira Matsuno

Department of Neurosurgery, International University of Health and Welfare, School of Medicine, Narita Hospital, Hatakeda, Narita, Japan

*Corresponding Author: Keisuke Onoda, Department of Neurosurgery, International University of Health and Welfare, School of Medicine, Narita Hospital Hatakeda, Narita, Japan.

Received: June 17, 2024; Published: August 26, 2024

Abstract

Microvascular decompression (MVD) is a fundamental treatment and standard procedure for hemifacial spasm (HFS). However, it is difficult to perform when the compressing vessel is the vertebral artery (VA). In addition, cases involving the bilateral VAs are rare, meaning that such surgeries lack precedent; thereby making them difficult. In this report, we describe the successful results of MVD for HFS involving bilateral VAs.

The patient was a 57-year-old man with left-sided HFS. He visited the hospital for surgery because he had developed the disease 10 years prior, and it had gradually worsened. Preoperative 3D magnetic resonance cisternogram/magnetic resonance cisternogram/angiogram fusion images showed that the left VA severely compressed the root exit zone of the facial nerve, while the right VA compressed it further from behind. Surgery was performed using the conventional retrosigmoid approach. The transposition and interposition were performed on the right and left VA, respectively, and favorable decompression of the facial nerve was achieved. The postoperative course was excellent, the HFS disappeared, and the patient was discharged without any complications.

MVD for HFS involving the bilateral VAs is challenging, and to avoid complications, a combination of other procedures should be considered in addition to transposition.

 Keywords: Hemifacial Spasm; Bilateral Vertebral Artery; Microvascular Decompression

References

1. Mizobuchi, Yoshifumi., et al. “Prospective, Multicenter Clinical Study of Microvascular Decompression for Hemifacial Spasm”. Neurosurgery4 (2021): 846-854.
2. Jannetta PJ and A Kassam. “Hemifacial spasm”. Journal of Neurology, Neurosurgery, and Psychiatry2 (1999): 255-256.
3. Inoue Takuro., et al. “Bridge technique for hemifacial spasm with vertebral artery involvement”. Acta Neurochirurgica12 (2021): 3311-3320.
4. Kim Joo Pyung., et al. “Microvascular decompression for hemifacial spasm associated with vertebrobasilar artery”. Journal of Korean Neurosurgical Society3 (2008): 131-135.
5. Lee Seunghoon., et al. “Involvement of the vertebral artery in hemifacial spasm: clinical features and surgical strategy”. Scientific Reports1 (2021): 4915.
6. Wang Jing., et al. “Microvascular decompression for hemifacial spasm involving the vertebral artery”. Acta Neurochirurgica3 (2022): 827-832.
7. Zhang Xin., et al. “The Effect of Microvascular Decompression on Hemifacial Spasm with Atherosclerosis of Vertebral Artery”. The Journal of Craniofacial Surgery6 (2017): e579-e582.
8. Shimano Hiroshi., et al. “Microvascular Decompression for Hemifacial Spasm Associated with Bilateral Vertebral Artery Compression”. World Neurosurgery4 (2015): 1178.e5-9.
9. Onoda Keisuke., et al. “A Case of Nervus Intermedius Neuralgia”. World Neurosurgery 137 (2020): 89-92.
10. Satoh Toru., et al. “Fusion imaging of three-dimensional magnetic resonance cisternograms and angiograms for the assessment of microvascular decompression in patients with hemifacial spasms”. Journal of Neurosurgery1 (2007): 82-89.

Citation

Citation: Keisuke Onoda., et al. “Hemifacial Spasm Associated with Bilateral Vertebral Arteries Compression”. Acta Scientific Neurology 7.9 (2024): 01-03.

Copyright

Copyright: © 2024 Keisuke Onoda., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.