Hemifacial spasm caused by unruptured fusiform vertebral aneurysm treated with endovascular coil embolization: a case report

Pengchen He; Zongping Li; Han Jiang

doi:10.3389/fneur.2023.1203751

Hemifacial spasm caused by unruptured fusiform vertebral aneurysm treated with endovascular coil embolization: a case report

Front Neurol. 2023 Jul 25:14:1203751. doi: 10.3389/fneur.2023.1203751. eCollection 2023.

Authors

Pengchen He¹, Zongping Li¹, Han Jiang²

Affiliations

¹ Department of Neurosurgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan, China.
² Department of Rehabilitation Therapy, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan, China.

Abstract

Hemifacial spasm due to fusiform aneurysm of the vertebral artery is extremely rare. The lateral spread response (LSR) is routinely used to monitor hemifacial spasms during microvascular decompression to predict the degree of postoperative remission of hemifacial spasm. We report a case of hemifacial spasm caused by an unruptured fusiform vertebral aneurysm treated with intravascular intervention and monitoring of LSR. A 59-year-old man was admitted to the hospital with a left facial spasm that gradually worsened for 1 year. Preoperative cerebrovascular angiography indicated fusiform aneurysms in the intracranial segment of the left vertebral artery close to the left facial nerve. The patient underwent parent artery occlusion and aneurysm embolization, and LSR was monitored intraoperatively. After intraoperative aneurysm embolization, LSR disappeared immediately. The postoperative review of cerebrovascular angiography indicated that the parent artery and aneurysm were embolized successfully, and the patient's left facial spasm was relieved after surgery. Hemifacial spasm caused by the vertebral artery fusiform aneurysm can be safely and effectively treated by parent artery occlusion and aneurysm embolization. Meanwhile, intraoperative LSR monitoring can be used to predict postoperative efficacy.

Keywords: fusiform aneurysm; hemifacial spasm; lateral spread response; occlusion; vertebral artery.

Publication types

Case Reports

Grants and funding

This study was supported by 2021 Scientific Research Project of Mianyang Municipal Commission of Health and Construction (202103), Hospital level Project of Mianyang Central Hospital (2021YJ004), and Incubation Project of Mianyang Central Hospital (2021FH007).