No shinkei geka. Neurological surgery
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Review Case Reports
[Hemifacial spasm caused by a dissecting aneurysm of the vertebral artery, and resulting in acute exacerbation].
The authors report a rare case of a symptomatic hemifacial spasm caused by a dissecting vertebral artery aneurysm and by an anterior inferior cerebellar artery(AICA). A 54-year-old man presented with left hemifacial spasm persisting for 5 years, and the spasm had undergone acute aggravation. ⋯ Microvascular decompression of the facial nerve with proximal clipping of the vertebral artery dissecting aneurysm was successfully performed. The hemifacial spasm disappeared immediately after the surgery.
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We report a case of blood blister-like aneurysm(BBA)on the posterior wall of the internal carotid artery(ICA)causing subarachnoid hemorrhage(SAH). A 45-year-old man suffering from SAH(WFNS grade 5)was referred to our hospital. 3D-CT angiography showed a BBA on the posterior wall of the ICA. The aneurysm had been enlarged for a few days. ⋯ To our knowledge, BBA on the posterior wall of the ICA is rare. Radical surgery with bypass should be performed as soon as possible when the BBA is found to regrow. We discuss the clinical characteristics with a review of the literature.