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Case Reports
Resolution of hemifacial spasm after surgical obliteration of a tentorial arteriovenous fistula: case report.
- Vivek R Deshmukh, Peter H Maughan, and Robert F Spetzler.
- Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
- Neurosurgery. 2006 Jan 1; 58 (1): E202; discussion E202.
Objective And ImportanceWe describe a patient with a tentorial dural arteriovenous fistula who presented with ipsilateral hemifacial spasm.Clinical PresentationA 50-year-old man sought treatment for left facial twitching that worsened over 6 months. Magnetic resonance imaging and catheter angiography demonstrated a left tentorial dural arteriovenous fistula.InterventionThe patient underwent a retrosigmoid craniotomy and ligation of the draining vein at the site of the fistula. Intraoperative angiography showed complete obliteration of the fistula. The patient's hemifacial spasm improved significantly after the fistula was obliterated.ConclusionPosterior fossa arteriovenous fistulas can present with a hemifacial spasm related to compression of the facial nerve by arterialized leptomeningeal veins. Microsurgical obliteration of the fistula can resolve the related symptoms.
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