面神经与中间神经间小脑前下动脉穿透致面肌痉挛1例。

NMC case report journal Pub Date : 2024-12-03 eCollection Date: 2024-01-01 DOI:10.2176/jns-nmc.2024-0167
Yuji Takano, Yoji Tanaka, Azumi Kaneoka, Mayuko Imamura, Kaoru Tamura, Taketoshi Maehara
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引用次数: 0

摘要

面肌痉挛(HFS)是一种由于血管压迫面神经而引起同侧面肌不自主运动的疾病。微血管减压(MVD)是一种外科手术,将罪魁祸首血管从神经上分离出来,被认为是治疗HFS最有效的方法。然而,在极少数血管穿透神经的情况下,将血管定位在离神经足够远的地方是有挑战性的。本文报告一例54岁男性右侧HFS患者,其小脑前下动脉已穿透面神经和中间神经之间的神经纤维间隙。在本病例中,患者痉挛得以缓解,术后面部偏瘫得以避免,方法是将裂缝轻微劈开,轻轻移动血管,并将其固定在颞骨的岩部。必须正确理解面神经与侵犯血管之间的解剖关系,在这种“穿透型”HFS病例中必须小心处理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Case of Hemifacial Spasm Caused by Penetration of the Anterior Inferior Cerebellar Artery between the Facial Nerve and the Nervus Intermedius.

Hemifacial spasm (HFS) is a disorder that causes involuntary movements of the ipsilateral facial muscles because of vascular compression of the facial nerve. Microvascular decompression (MVD), a surgical procedure to detach the culprit vessel from the nerve is believed to be the most effective treatment for HFS. Nevertheless, in the rare case in which the vessel penetrates the nerve, positioning the vessel sufficiently far from the nerve is challenging. In this report, a case of right HFS in a 54-year-old man with an anterior inferior cerebellar artery that had penetrated the nerve fiber cleft between the facial nerve and the nervus intermedius is presented. In the present case, the patient achieved relief from spasm, and postoperative facial hemiplegia was prevented by splitting the cleft slightly, gently moving the vessel, and affixing it to the petrous part of the temporal bone. The anatomic relationship between the facial nerve and the offending vessel must be properly understood, which must be carefully manipulated in such "penetration-type" HFS cases.

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