Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
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Case Report

Volume 16, Number 8, August 2025, pages 323-329

A Successful Treatment of Hemifacial Spasm After Flow Diverter Stent Placement for Ipsilateral Internal Carotid Artery Saccular Aneurysm

Figures

Figure 1.
Figure 1. Appearance consistent with hemifacial spasm (HFS) prior to the patient’s treatment.
Figure 2.
Figure 2. (a, b) Magnetic resonance angiography (MRA) reveals a saccular aneurysm arising from the cavernous-ophthalmic segment of the right internal carotid artery (ICA), as indicated by the red arrow.
Figure 3.
Figure 3. (a, b) Digital subtraction angiography (DSA) images demonstrate a saccular aneurysm located in the cavernous-ophthalmic segment of the right internal carotid artery (ICA). The aneurysmal dome is marked with black arrows in both panels.
Figure 4.
Figure 4. Digital subtraction angiography (DSA) demonstrates the deployment of a flow diverter stent across a saccular aneurysm located in the cavernous-ophthalmic segment of the right internal carotid artery (ICA). The stent position and covered aneurysmal segment are indicated by black arrows.
Figure 5.
Figure 5. The patient’s symptoms regressed after treatment.

Table

Table 1. Summary of Reported Cases of Hemifacial Spasm Associated With Intracranial Aneurysms (n = 23)
 
Case No.Author and yearAge/sexAN locationAN type and offending vesselTreatmentOutcome
AN: aneurysm; AICA: anterior inferior cerebellar artery; BA: basilar artery; Coil: endovascular coil embolization; DED: Derivo embolization device; ICA: internal carotid artery; MVD: microvascular decompression; PAO: parent artery occlusion; PICA: posterior inferior cerebellar artery; SAC: stent-assisted coiling; VA: vertebral artery; V3/V4: vertebral artery segments.
1Nagashima et al, 2001 [12]69/MVA-BA junctionDissectionPAOCure
2Sato et al, 2001 [13]53/MPICAFusiform ANPAOCure
3Murakami et al, 2004 [14]49/FV3-V4 junctionSaccular ANPAOCure
4Matsumoto et al, 2005 [15]62/FPICASaccular ANPAOCure
5Nakagawa et al, 2011 [16]55/FVA unionFusiform ANPAOCure
6Kugai et al, 2019 [5]56/MVA unionSaccular ANPAOCure
7Santiago-Dieppa et al, 2019 [17]60/FV4 segmentSaccular ANPAOCure
8Arisawa et al, 2020 [8]62/FV4 segmentSaccular ANSACRecurrence
9Iida et al, 2020 [9]59/MVA-PICASaccular ANCoilCure
10Satoh et al, 2022 [18]50/MV4 segmentDissectionStentCure
11Ko et al, 2022 [6]42/MV4 segmentDissection + PICAPAOCure after MVD
12Matsumoto et al, 1991 [10]58/MV4 segmentDissectionMVDCure
13Nagata et al, 1992 [4]70/FVA-PICASaccular ANClipCure
14Moriuchi et al, 1996 [19]62/FVA-PICASaccular ANClip + MVDCure
15Tsuchiya et al, 2000 [20]71/FV4 segmentFusiform AN + AICAClip + MVDCure
16Uchino et al, 2005 [11]59/FV4 segmentFusiform ANMVDCure
17Choi et al, 2008 [21]45/MV4 segmentFusiform AN + PICAMVDCure
18Furtado et al, 2013 [22]50/FV4 segmentSaccular AN + VAClip + MVDCure
19Lee et al, 2015 [23]69/MV4 segmentDissectionMVDCure
20Chang et al, 2021 [24]17/MAICASaccular ANClip + MVDCure
21Arai et al, 2022 [25]64/MV4 segmentFusiform AN + AICAMVDCure
22Inoue et al, 2023 [26]68/MVA-PICASaccular ANClip + MVDCure
23Present case56/FICA cavernous-ophthalmicSaccular ANFlow diverter stentCure