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Improvement of Hemifacial Spasm after Stent-assisted Coil Embolization for Ipsilateral Vertebral Artery Dissecting Aneurysm
Microvascular decompression (MVD) is the gold standard in the treatment of hemifacial spasm (HFS), and endovascular surgery has been described as a treatment only for aneurysm-induced HFS in several previous cases. We describe symptomatic HFS caused by a normal vertebral artery (VA) trunk adjacent t...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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The Japan Neurosurgical Society
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8769391/ https://www.ncbi.nlm.nih.gov/pubmed/35079456 http://dx.doi.org/10.2176/nmccrj.cr.2020-0121 |
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author | MIYAZAKI, Yuko MATSUBARA, Shunji ISHIHARA, Manabu MINAMI, Yukari Ogawa KINOSHITA, Keita TAKAI, Hiroki HIRAI, Satoshi HARA, Keijirou YAGI, Kenji UNO, Masaaki |
author_facet | MIYAZAKI, Yuko MATSUBARA, Shunji ISHIHARA, Manabu MINAMI, Yukari Ogawa KINOSHITA, Keita TAKAI, Hiroki HIRAI, Satoshi HARA, Keijirou YAGI, Kenji UNO, Masaaki |
author_sort | MIYAZAKI, Yuko |
collection | PubMed |
description | Microvascular decompression (MVD) is the gold standard in the treatment of hemifacial spasm (HFS), and endovascular surgery has been described as a treatment only for aneurysm-induced HFS in several previous cases. We describe symptomatic HFS caused by a normal vertebral artery (VA) trunk adjacent to the ipsilateral dissecting VA aneurysm completely cured after stent-assisted coil embolization. A 52-year-old man presented with a 2-month history of gradually worsening left HFS. Magnetic resonance imaging (MRI) and cerebral angiography revealed a dissecting VA aneurysm on the left side. Based on the findings from preoperative MRI, not the aneurysmal dome itself, but the VA trunk just distal to the aneurysmal dome was considered likely to be compressing the root exit zone (REZ) of the facial nerve. Stent-assisted coil embolization was conducted for the VA aneurysm, and the stent was deployed to cover the wide neck of the aneurysm and offending zone of the VA trunk simultaneously. HFS started to show improvement just after the procedure and complete disappearance within 1 year. HFS was completely resolved by stenting of the offending artery. Stents may show efficacy for “intra-arterial decompression” by reducing pulsatility against the REZ of the facial nerve due to the thickness and rigidity of the stent metal and delayed endothelialization. |
format | Online Article Text |
id | pubmed-8769391 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | The Japan Neurosurgical Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-87693912022-01-24 Improvement of Hemifacial Spasm after Stent-assisted Coil Embolization for Ipsilateral Vertebral Artery Dissecting Aneurysm MIYAZAKI, Yuko MATSUBARA, Shunji ISHIHARA, Manabu MINAMI, Yukari Ogawa KINOSHITA, Keita TAKAI, Hiroki HIRAI, Satoshi HARA, Keijirou YAGI, Kenji UNO, Masaaki NMC Case Rep J Case Report Microvascular decompression (MVD) is the gold standard in the treatment of hemifacial spasm (HFS), and endovascular surgery has been described as a treatment only for aneurysm-induced HFS in several previous cases. We describe symptomatic HFS caused by a normal vertebral artery (VA) trunk adjacent to the ipsilateral dissecting VA aneurysm completely cured after stent-assisted coil embolization. A 52-year-old man presented with a 2-month history of gradually worsening left HFS. Magnetic resonance imaging (MRI) and cerebral angiography revealed a dissecting VA aneurysm on the left side. Based on the findings from preoperative MRI, not the aneurysmal dome itself, but the VA trunk just distal to the aneurysmal dome was considered likely to be compressing the root exit zone (REZ) of the facial nerve. Stent-assisted coil embolization was conducted for the VA aneurysm, and the stent was deployed to cover the wide neck of the aneurysm and offending zone of the VA trunk simultaneously. HFS started to show improvement just after the procedure and complete disappearance within 1 year. HFS was completely resolved by stenting of the offending artery. Stents may show efficacy for “intra-arterial decompression” by reducing pulsatility against the REZ of the facial nerve due to the thickness and rigidity of the stent metal and delayed endothelialization. The Japan Neurosurgical Society 2021-06-05 /pmc/articles/PMC8769391/ /pubmed/35079456 http://dx.doi.org/10.2176/nmccrj.cr.2020-0121 Text en © 2021 The Japan Neurosurgical Society https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) |
spellingShingle | Case Report MIYAZAKI, Yuko MATSUBARA, Shunji ISHIHARA, Manabu MINAMI, Yukari Ogawa KINOSHITA, Keita TAKAI, Hiroki HIRAI, Satoshi HARA, Keijirou YAGI, Kenji UNO, Masaaki Improvement of Hemifacial Spasm after Stent-assisted Coil Embolization for Ipsilateral Vertebral Artery Dissecting Aneurysm |
title | Improvement of Hemifacial Spasm after Stent-assisted Coil Embolization for Ipsilateral Vertebral Artery Dissecting Aneurysm |
title_full | Improvement of Hemifacial Spasm after Stent-assisted Coil Embolization for Ipsilateral Vertebral Artery Dissecting Aneurysm |
title_fullStr | Improvement of Hemifacial Spasm after Stent-assisted Coil Embolization for Ipsilateral Vertebral Artery Dissecting Aneurysm |
title_full_unstemmed | Improvement of Hemifacial Spasm after Stent-assisted Coil Embolization for Ipsilateral Vertebral Artery Dissecting Aneurysm |
title_short | Improvement of Hemifacial Spasm after Stent-assisted Coil Embolization for Ipsilateral Vertebral Artery Dissecting Aneurysm |
title_sort | improvement of hemifacial spasm after stent-assisted coil embolization for ipsilateral vertebral artery dissecting aneurysm |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8769391/ https://www.ncbi.nlm.nih.gov/pubmed/35079456 http://dx.doi.org/10.2176/nmccrj.cr.2020-0121 |
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