2019 Volume 13 Issue 7 Pages 288-292
Objective: The authors report a rare case of symptomatic unruptured fusiform vertebral artery (VA) aneurysm causing hemifacial spasm, which was successfully treated by endovascular parent artery occlusion (PAO).
Case Presentation: A 56-year-old man presented with left hemifacial spasm, and the symptom progressed rapidly over 3–4 weeks including difficulty of eye opening. Brain MRI showed a left fusiform VA aneurysm with a maximum diameter of approximately 10 mm, which compressed the root exit zone (REZ) of the left facial nerve. Endovascular PAO of the left VA was performed with coils. The hemifacial spasm disappeared immediately after PAO. The size of the aneurysm was markedly reduced on MRI on the next day. No recurrence of the hemifacial spasm and aneurysm was observed after half a year after PAO.
Conclusion: This rare case suggested that endovascular PAO may be an effective treatment for hemifacial spasm caused by a relatively large aneurysm.
