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. Appearance consistent with hemifacial spasm (HFS) prior to the patient’s treatment.
Figure 1.
↓  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 2.
↓  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 3.
↓  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 4.
↓  Figure 5. The patient’s symptoms regressed after treatment.
Figure 5.

Table

↓  Table 1. Summary of Reported Cases of Hemifacial Spasm Associated With Intracranial Aneurysms (n = 23)
 
Case No. Author and year Age/sex AN location AN type and offending vessel Treatment Outcome
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.
1 Nagashima et al, 2001 [12] 69/M VA-BA junction Dissection PAO Cure
2 Sato et al, 2001 [13] 53/M PICA Fusiform AN PAO Cure
3 Murakami et al, 2004 [14] 49/F V3-V4 junction Saccular AN PAO Cure
4 Matsumoto et al, 2005 [15] 62/F PICA Saccular AN PAO Cure
5 Nakagawa et al, 2011 [16] 55/F VA union Fusiform AN PAO Cure
6 Kugai et al, 2019 [5] 56/M VA union Saccular AN PAO Cure
7 Santiago-Dieppa et al, 2019 [17] 60/F V4 segment Saccular AN PAO Cure
8 Arisawa et al, 2020 [8] 62/F V4 segment Saccular AN SAC Recurrence
9 Iida et al, 2020 [9] 59/M VA-PICA Saccular AN Coil Cure
10 Satoh et al, 2022 [18] 50/M V4 segment Dissection Stent Cure
11 Ko et al, 2022 [6] 42/M V4 segment Dissection + PICA PAO Cure after MVD
12 Matsumoto et al, 1991 [10] 58/M V4 segment Dissection MVD Cure
13 Nagata et al, 1992 [4] 70/F VA-PICA Saccular AN Clip Cure
14 Moriuchi et al, 1996 [19] 62/F VA-PICA Saccular AN Clip + MVD Cure
15 Tsuchiya et al, 2000 [20] 71/F V4 segment Fusiform AN + AICA Clip + MVD Cure
16 Uchino et al, 2005 [11] 59/F V4 segment Fusiform AN MVD Cure
17 Choi et al, 2008 [21] 45/M V4 segment Fusiform AN + PICA MVD Cure
18 Furtado et al, 2013 [22] 50/F V4 segment Saccular AN + VA Clip + MVD Cure
19 Lee et al, 2015 [23] 69/M V4 segment Dissection MVD Cure
20 Chang et al, 2021 [24] 17/M AICA Saccular AN Clip + MVD Cure
21 Arai et al, 2022 [25] 64/M V4 segment Fusiform AN + AICA MVD Cure
22 Inoue et al, 2023 [26] 68/M VA-PICA Saccular AN Clip + MVD Cure
23 Present case 56/F ICA cavernous-ophthalmic Saccular AN Flow diverter stent Cure