Significance of Anomalous Anterior Inferior Cerebellar Artery-Posterior Inferior Cerebellar Artery Common Trunk Compression in Microvascular Decompression for Hemifacial Spasm

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• 作者：Hiroshi Shimano ; ^{shimano@shiroyama-hsp.or.jp" class="auth_mail" title="E-mail the corresponding author} ; Akinori Kondo ; Soichiro Yasuda ; Hiroto Inoue ; Jun Morioka ; Hiroshi Miwa ; Osamu Kawakami ; Kenichi Murao
• 关键词：Anterior inferior cerebellar artery ; Common trunk anomaly ; Hemifacial spasm ; Microvascular decompression ; Posterior inferior cerebellar artery
• 刊名：World Neurosurgery
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：92
• 期：Complete
• 页码：15-22
• 全文大小：4967 K

文摘

The anterior inferior cerebellar artery–posterior inferior cerebellar artery (AICA–PICA) common trunk anomaly is reportedly one of the most common vessel variants in the posterior circulation, but reports of hemifacial spasm (HFS) associated with AICA–PICA common trunk are very rare. In the present study, we describe methods of microvascular decompression (MVD) for HFS caused by AICA–PICA common trunk compression.

Methods

Among 159 patients who underwent MVD for HFS, 16 patients had compression of the root exit zone by the AICA–PICA common trunk anomaly. The types of compression were classified into 2 groups: common trunk artery compression group and branching vessel compression group.

Results

The common trunk artery compression group consisted of 11 patients (69%), and the branching vessel compression group consisted of 5 patients (31%). The rostral branch (feeding the original AICA territory) coursed between the seventh and eighth cranial nerves in 5 patients, and in 13 patients (81%), the offending vessel harbored perforators around the root exit zone. Among 16 patients, 14 (87.5%) required interposition of the common trunk or the branching vessel, and in 2 patients, decompression was completed by the transposition method. Fifteen patients experienced sufficient results, and 1 had severe residual spasm. Transient facial palsy developed in 2 patients. No patients encountered recurrence.

Conclusions

Reports concerning decompression methods of AICA–PICA common trunk anomaly are very rare. The tortuosity of the common trunk and perforators from the offending vessel make the usual repositioning of the offending artery much more difficult, and adequate decompression techniques are required for successful MVD.