This paper reports that decompression of the facial nerve by transarterial Onyx embolization may relieve hemifacial spasm (HFS) caused by dilated veins due to a right petrosal dural arteriovenous fistula (DAVF).
A 56-year-old man suffered severe chronic right HFS associated with a dilated right petrosal vein lying in the vicinity of the facial nerve.
The right petrosal DAVF was reached through the middle meningeal artery using a transfemoral arterial approach and was occluded with Onyx 18 (M.T.I.- ev3, Irvine, CA, USA). There was complete remission of HFS without recurrence after two months of follow-up.
This case supports vascular compression in the pathogenesis of HFS and suggests that facial nerve injury caused by a DAVF could be treated with transarterial Onyx embolization.
JannettaPJ. Hemifacial spasm caused by a venule: Case report. Neurosurgery. 1984; 14: 89–92.
3.
NeimatJSHohBLMcKennaMJ. Aneurysmal expansion presenting as facial weakness: Case report and review of the literature. Neurosurgery. 2005; 56: 190.
4.
KonanAVRoyDRaymondJ. Endovascular treatment of hemifacial spasm associated with a cerebral arteriovenous malformation using transvenous embolization: Case report. Neurosurgery. 1999; 44: 663–666.
5.
NagataSFujiiKNomuraT. Hemifacial spasm caused by CP angle AVM associated with ruptured aneurysm in the feeding artery—case report. Neurol Med Chir (Tokyo). 1991; 31: 406–409.
6.
BuettnerUWStöhrMKoletzkiE. Brainstem auditory evoked potential abnormalities in vascular malformations of the posterior fossa. J Neurol. 1983; 229: 247–254.
TokimuraHAtsuchiMTodorokiK. A case of cerebellar arteriovenous malformation with hemifacial spasm at onset. No Shinkei Geka. 1988; 16: 769–773.
9.
MilaniNScaioliVGiombiniS. Hemifacial spasm in a child. Childs Nerv Syst.1991; 7: 466–468.
10.
NagataSMatsushimaTFujiiK. Hemifacial spasm due to tumor, aneurysm, or arteriovenous malformation. Surg Neurol. 1992; 38: 204–209.
11.
DeshmukhVRMaughanPHSpetzlerRF. Resolution of hemifacial spasm after surgical obliteration of a tentorial arteriovenous fistula: Case report. Neurosurgery. 2006; 58: E202.
12.
LvXJiangCLiY. Transarterial embolization of tentorial dural arteriovenous fistulas with Onyx-18. Neuroradiol J.2008; 21: 406–414.
13.
AratAInciS. Treatment of a superior sagittal sinus dural arteriovenous fistula with Onyx: Technical case report. Neurosurgery. 2006; 59: 169–170.
14.
CognardCJanuelACSilvaNAJr. Endovascular treatment of intracranial dural arteriovenous fistulas with cortical venous drainage: New management using Onyx. Am J Neuroradiol. 2008; 29: 235–241.
15.
NogueiraRGDabusGRabinovJD. Preliminary experience with onyx embolization for the treatment of intracranial dural arteriovenous fistulas. Am J Neuroradiol. 2008; 29: 91–97.
16.
RezendeMTPiotinMMounayerC. Dural arteriovenous fistula of the lesser sphenoid wing region treated with Onyx: Technical note. Neuroradiology. 2006; 48: 130–134.
17.
ToulgoatFMounayerCRezendeTulio Salles M. Transarterial embolisation of intracranial dural arteriovenous malformations with ethylene vinyl alcohol copolymer (Onyx18). J Neuroradiol. 2006; 33: 105–114.
18.
LvXJiangCLiY. Results and complications of transarterial embolization of intracranial dural arteriovenous fistulas using Onyx-18. J Neurosurg. 2008; 109: 1083–1090.
19.
CdeLucas PMounayerCSpelleL. Endoarterial management of dural arteriovenous malformations with isolated sinus using Onyx-18: Technical case report. Neurosurgery. 2007; 61 (5Suppl. 2): E293–294.
20.
StiefelMFAlbuquerqueFCParkMS. Endovascular treatment of intracranial dural arteriovenous fistulae using Onyx: A case series. Neurosurgery. 2009; 65 (ONS Suppl 1): ons132–ons140.
21.
LvXJiangCZhangJ. Complications related to percutaneous transarterial embolization of intracranial dural arteriovenous fistulas in 40 patients. Am J Neuroradiol. 2009; 30: 462–468.
