Resolution of hemifacial spasm after surgical obliteration of a tentorial arteriovenous fistula: case report.
OBJECTIVE
We describe a patient with a tentorial dural arteriovenous fistula who presented with ipsilateral hemifacial spasm.


METHODS
A 50-year-old man sought treatment for left facial twitching that worsened over 6 months. Magnetic resonance imaging and catheter angiography demonstrated a left tentorial dural arteriovenous fistula.


METHODS
The patient underwent a retrosigmoid craniotomy and ligation of the draining vein at the site of the fistula. Intraoperative angiography showed complete obliteration of the fistula. The patient's hemifacial spasm improved significantly after the fistula was obliterated.


CONCLUSIONS
Posterior fossa arteriovenous fistulas can present with a hemifacial spasm related to compression of the facial nerve by arterialized leptomeningeal veins. Microsurgical obliteration of the fistula can resolve the related symptoms.
Deshmukh
Vivek R
VR
Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
Maughan
Peter H
PH
Spetzler
Robert F
RF
D001164:Arteriovenous Fistula / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002531:Cerebellum / Q000098:blood supply*; D002533:Cerebral Angiography; D003399:Craniotomy; D004388:Dura Mater / Q000098:blood supply*; D019569:Hemifacial Spasm / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D007432:Intraoperative Period; D008026:Ligation; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012074:Remission Induction