Abstract
We present a case of a 45-year-old male patient with left hemifacial spasm for 6 years. Magnetic resonance tomographic angiography confirmed that there were small vessels adjacent to the left facial nerve root entry zone, but the left internal carotid artery (ICA) was absent. Magnetic resonance angiography using three-dimensional time of flight technique showed the absence of the left ICA and vertebral artery, But the presence of a 6-mm aneurysm in the bifurcation of the right internal carotid artery. These abnormal arterial structures were further confirmed by angiogram. Aortic arch angiogram revealed a right-sided aortic arch and the Subclavian steal phenomenon. The left common carotid artery and the left Subclavian artery were absent. Right vertebral angiography showed retrograde filling of the left vertebral artery. The left upper limb was fed by this artery. The aneurysm was successfully clipped. Post-operatively, the hemifacial spasm was weakened. However, the operation did not change the neurovascular positional relationship, thus we advised follow-up visits. Cerebral artery anomalies should be taken into consideration when performing imaging and surgical corrections in patients with hemifacial spasm.
Similar content being viewed by others
References
Afifi AK, Godersky JC, Menezes A, Smoker WR, Bell WE, Jacoby CG (1987) Cerebral hemiatrophy, hypoplasia of internal carotid artery, and intracranial aneurysm. Arch Neurol 44:232–235
Barker FG, Jannetta PJ, Bissonette DJ, Shields PT, Larkins MV, Jho HD (1995) Microvascular decompression for hemifacial spasm. J Neurosurgery 82:201–210
Bhattacharya JJ, Luo CB, Alvarez H, Rodesch G, Pongpech S, Lasjaunias P (2004) PHACES syndrome: a review of eight unreported cases with late arterial occlusive manifestations. Neuroradiology 46:227–233
Damry N, Hanquinet S, Christophe C, Janssen F, Delatte P, Perlmutter N (1994) Bilateral congenital absence of the internal carotid artery with a primitive transmaxillary arterial anastomosis. Pediatr Radiol 24:200–203
Fukuda M, Kameyama S, Takahashi H, Tanaka R (1998) Trigeminal neuralgia caused by the vertebral artery associated with primitive trigeminal artery and agenesis of the internal carotid artery. Neurol Med Chir (Tokyo) 38:367–370
Given CA II, Huang-Hellinger F, Baker MD, Chepuri NB, Morris PP (2001) Congenital absence of the internal carotid artery: case reports and review of the collateral circulation. AJNR Am J Neuroradiol 22:1953–1959
Jannetta PJ (1996) Cranial rhizopathies. In: Youmans JR (ed) Neurol Surg, 4th edn. WB Saunders, Philadelphia, pp 3563–3574
Kikuchi K, Kowada M, Kojima H (1995) Hypoplasia of the internal carotid artery associated with spasmodic torticollis: the possible role of altered vertebrobasilar haemodynamics. Neuroradiology 37:362–364
Lie TA (1968) Congenital anomalies of the carotid arteries. Excerpta Medica, Amsterdam, pp 35–51
Niijima KH, Yonekawa Y, Kaku Y (1990) Disappearance of hemifacial spasm following spinal drainage: a case report. Neurol Surg (Tokyo) 18:577–580
Teal JS, Naheedy MH, Hasso AN (1980) Total agenesis of the internal carotid artery. AJNR Am J Neuroradiol 1:435–442
Wakai S, Watanabe N, Inoh S, Ochiai C, Nagai M (1987) Agenesis of internal carotid artery presenting with oculomotor nerve palsy after minor head injury. Neurosurgery 20:794–796
Weon YC, Chung JI, Kim HJ (2005) Agenesis of bilateral internal carotid arteries and posterior fossa abnormality in a patient with facial capillary hemangioma: presumed incomplete phenotypic expression of PHACE syndrome. AJNR Am J Neuroradiol 26:2635–2639
Yamashita K, Hojo M, Okamoto S, Kim C, Nakatsu S, Mishima H (1997) Possible role of neurointerventional techniques in the diagnosis of hemifacial spasm. AJNR Am J Neuroradiol 18:287–290
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Xie, T., Zhang, XB., Li, QP. et al. Hemifacial spasm patient with ipsilateral total absence of common carotid artery, vertebral artery and aneurysm of the contralateral internal carotid artery. Surg Radiol Anat 32, 707–710 (2010). https://doi.org/10.1007/s00276-010-0660-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00276-010-0660-2