Twists of trouble: AICA loops as the culprit in hemifacial spasm

Abstract

The highly variable anatomy of the anterior inferior cerebellar artery is one of the causative factors of neurovascular compression of the facial and vestibulocochlear nerve resulting in hemifacial spasms associated with hearing loss, vertigo, and tinnitus. Our patient a 64-year-old male presented with such complaints for the past few months. He was investigated thoroughly for the cause and on Magnetic resonance imaging of the brain with Fast imaging employing steady-state acquisition sequence it was evident that the anterior inferior cerebellar artery loop was compressing the seventh and eighth cranial nerves on the right side. This was responsible for the patient’s symptoms. He also had sensorineural hearing loss in the right ear. He was started on symptomatic treatment as he denied any surgical intervention.