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Arachnoid cyst alone causes hemifacial spasm: illustrative case

BACKGROUND: Hemifacial spasm (HFS) due to an arachnoid cyst at the cerebellopontine angle is rare. Here, the authors reported such a case and analyzed the mechanism of facial nerve hyperactivity by reviewing the literature. OBSERVATIONS: A 40-year-old man presented with right HFS for the past 3 year...

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Detalles Bibliográficos
Autores principales: Ozaki, Ko, Higuchi, Yoshinori, Nakano, Shigeki, Horiguchi, Kentaro, Yamakami, Iwao, Iwadate, Yasuo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Association of Neurological Surgeons 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9379708/
https://www.ncbi.nlm.nih.gov/pubmed/36303502
http://dx.doi.org/10.3171/CASE2275
Descripción
Sumario:BACKGROUND: Hemifacial spasm (HFS) due to an arachnoid cyst at the cerebellopontine angle is rare. Here, the authors reported such a case and analyzed the mechanism of facial nerve hyperactivity by reviewing the literature. OBSERVATIONS: A 40-year-old man presented with right HFS for the past 3 years. Preoperative magnetic resonance imaging revealed a right cerebellopontine angle cystic mass with high intensity on T2-weighted images, low intensity on T1-weighted and diffusion-weighted images, and no contrast effects. Cyst excision and decompression of the facial nerve using a lateral suboccipital approach to monitor abnormal muscle response (AMR) resulted in permanent relief. The cyst was histologically compatible with an arachnoid cyst. LESSONS: In the present case, when the cyst was dissected, the AMR disappeared and no offending arteries were detected around the root exit zone. Therefore, the cyst itself was responsible for HFS, for which AMR was useful. Limited cases of HFS due to arachnoid cysts without neurovascular compression have been previously reported. The authors suggested that pulsatile compression by the cyst results in facial nerve hyperactivity and secondary HFS.