Hemifacial spasm: neurovascular compressive patterns and surgical significance.

Full Abstract

BACKGROUND: The aim of this study was to report further investigation of neurovascular compression as a cause of hemifacial spasm (HFS) and to provide useful surgical guidelines by describing the compression patterns. MATERIAL AND METHODS: From January 2004 to February 2006, 236 consecutive patients with HFS underwent microvascular decompression (MVD) in a single centre. Based on the operation and medical records, the intraoperative findings and post-operative outcomes were obtained and analysed. RESULTS: We found that 95.3% of lesions had accompanying causative factors that made the neurovascular compression inevitable. Based on the contributing factors, compression patterns were categorised into six different types including: loop (n = 11: 4.6%), arachnoid (n = 66: 27.9%), perforator (n = 58: 24.6%), branch (n = 18: 7.6%), sandwich (n = 28: 11.9%), and tandem (n = 52: 22.0%). The compression patterns were significantly correlated with the compressing vessels involved. Thirty-two (86.5%) of 37 lesions where the vertebral artery was the compressing vessel involved the tandem type. Anterior inferior cerebellar artery was the compressing vessel involved in 49 (84.5%) of 58 perforator type compressions, while posterior inferior cerebellar artery was the compressing vessel involved in 8 (72.7%) of 11 loop type compressions. CONCLUSIONS: Once the compressing vessel responsible for the neurovascular compression are identified, the probable pattern of compression can be anticipated; this knowledge could facilitate the application of the appropriate operative procedures and minimise post-operative complications.

Author information

Author/s: Park, J S (JS); Kong, D-S (DS); Lee, J-A (JA); Park, K (K);

Affiliation: Samsung Medical Center, Department of Neurosurgery, School of Medicine, Sungkyunkwan University, Seoul, South Korea.

Journal and publication information

Publication Type: Journal Article

Journal: Acta neurochirurgica (Acta Neurochir (Wien)), published in Austria. (Language: eng)

Reference: 2008-Mar; vol 150 (issue 3) : pp 235-41; discussion 241

Dates: Created 2008/03/12; Completed 2008/04/10;

PMID: 18297233, status: MEDLINE (last retrieved date: 2/18/2009)

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