Endovascular treatment of hemifacial spasm associated with a cerebral arteriovenous malformation using transvenous embolization: Case report

OBJECTIVE AND IMPORTANCE: To illustrate that decompression of the facial ne rve by transvenous endovascular treatment may relieve hemifacial spasm (HFS ) caused by dilated veins. CLINICAL PRESENTATION: A 35-year-old man suffered severe chronic right LIES associated with a dilated right lateral mesencephalic vein lying in the vi cinity of the facial nerve. This nonessential vein was recruited as a secon dary collateral drainage from an inoperable left temporo-occipital arteriov enous malformation. INTERVENTION: The lateral mesencephalic vein was reached through the superi or petrosal sinus using a transfemoral venous approach and was occluded wit h interlocking detachable coils (Target Therapeutics, Freemont, CA). There was complete remission of HFS without recurrence after 2.5 years of follow- up. CONCLUSION: This case report supports vascular compression in the pathogene sis of LIES and suggests that facial nerve injury is not essential for the therapeutic effect of surgical decompression.