Abstract
The authors report a rare case of a hemifacial spasm associated with ipsilateral trigeminal neuralgia caused by the vascular compression of two independent cerebellar arteries. The patient, a 33-year-old woman, had complained of twitching of the right facial muscles and an intermittent facial pain. On admission to hospital, the findings of her neurological examination were normal, except for intermittent facial twitching and pain. Thus, to remedy this, neurovascular decompression surgery was performed on these two lesions through a right suboccipital craniectomy. For the hemifacial spasm, an inferior paramastoid approach was ' used, and to alleviate the trigeminal neuralgia, the infratentorial lateral supracerebellar approach was used during the same craniectomy. After this neurovascular decompression was accomplished , the symptoms disappeared and no postoperative complications occurred. When two separate procedures are required for two different lesions through one craniectomy, a different anatomical approach for each respective lesion should be considered, since different operative approaches should be employed to prevent traction of the acoustic nerve.
