Surgical anatomy for hemifacial spasm - 18/06/18

Doi : 10.1016/j.neuchi.2018.04.008

P. Mercier ^a,^⁎ , F. Bernard ^a,^b
^a Department of anatomy, UFR de médecine, university of Angers, rue haute-de-reculée, 49045 Angers cedex, France
^b Department of neurosurgery, CHU d’Angers, rue Larrey, 49033 Angers cedex, France

^⁎Corresponding author.

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Abstract

Classically in the cerebello-pontine angle the facial (CN VII) and vestibular-cochlear (CN VIII) nerves should run parallel with the anterior inferior cerebellar artery, whereas the lower nerves (CN IX-XI) continue with the posterior-inferior-cerebellar artery (PICA). In fact, this is not always true, particularly when dealing with hemispasm surgery where the relationships between CN VII, CN VIII and PICA are often different and closer. Knowledge of anatomical bases in surgical situation will help neurosurgeons to appreciate anatomical nuances, that are important to increase effectiveness and safety of hemifacial spasm surgery.

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Keywords : Vascular anatomy, Cranial nerves, Hemifacial spasm, Neurovascular conflict, Microvascular decompression, Surgical techniques