{"id":"9df84a3e-5a9d-4dbc-8c5e-99412e0dccdc","slug":"hemifacial-spasm-due-to-multiple-neurovascular-conflicts-a-conundrum","title":"Hemifacial spasm due to multiple neurovascular conflicts: A conundrum","authors":["Charandeep Singh Gandhoke","Anil Kumar Sharma","Raghavendra Kumar Sharma","Simran Kaur Syal"],"abstract":"Background: Hemifacial spasm is typically caused by compression of the facial nerve at the root exit zone (REZ) by a vessel, most commonly the anterior inferior cerebellar artery (AICA). This case presents a 54-year-old male with hemifacial spasm due to multiple neurovascular conflicts involving the dolichoectatic basilar artery and AICA. Summary: Radiological examination revealed dolichoectasia of the right vertebrobasilar artery compressing the right 7th-8th nerve complex. During surgery, multiple neurovascular conflicts were identified, and Teflon patches were placed to alleviate the compression while preserving a branch of AICA that traversed through the nerve complex. Postoperative assessment indicated complete resolution of the hemifacial spasm. Conclusion: This case highlights the complexity of managing hemifacial spasm due to multiple neurovascular conflicts. It emphasizes the importance of preserving critical vascular structures during surgical intervention to achieve optimal outcomes. Keywords: hemifacial spasm, neurovascular conflict, dolichoectasia, anterior inferior cerebellar artery, microvascular decompression, facial nerve, surgery","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/9df84a3e-5a9d-4dbc-8c5e-99412e0dccdc/featured/hero-1781563339257.png","publishDate":"2020-07-11T00:00:00.000Z","doi":"10.25259/SNI_140_2020","categories":["Unique Case Observations","Image Report"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/9df84a3e-5a9d-4dbc-8c5e-99412e0dccdc/pdf"}