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Article: A case-controlled MRI/MRA study of neurovascular contact in hemifacial spasm

TitleA case-controlled MRI/MRA study of neurovascular contact in hemifacial spasm
Authors
Issue Date1999
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.neurology.org
Citation
Neurology, 1999, v. 53 n. 9, p. 2132-2139 How to Cite?
AbstractBackground: Neurovascular contact (NVC) with the root exit zone (REZ) of the ipsilateral facial nerve is associated with hemifacial spasm (HFS, but unresolved issues remain. Objectives: To 1) determine the frequency of symptomatic and nonsymptomatic NVC, 2) determine the features of NVC associated with HFS, and 3) correlate severity of HFS to these features. Methods: Two independent, blinded, prospective assessments of high-resolution MR and MR angiography (MRA) images were performed on Chinese cases (HFS: n = 44; age-matched control subjects: n = 20). Results: Over 88% of 44 symptomatic sides in patients with HFS had NVC of the ipsilateral facial nerve. At least 80% of symptomatic sides involved NVC at the anterior aspect of the REZ [REZ(ant.)]. Although NVC was observed in approximately half of nonsymptomatic sides, at least 70% of them were not at REZ(ant.). NVC at the cisternal and intracanalicular portions of the facial nerve were not associated with HFS. Half of our patients with HFS had bilateral NVC, but none had bilateral symptoms. Most of our MR/MRA images showed that the size and position of the arterial branches of the vertebrobasilar system were markedly asymmetric. Of patients with bilateral NVC, over 83% had asymmetric NVC sites. The anterior inferior cerebellar artery was the most common vessel involved in NVC, but was not significantly associated with HFS. Most of the NVC involved one vessel at one contact point with no indentation. The development of HFS was significantly associated with nerve indentation in NVC. The development and severity of HFS were not associated with multiple contact points in NVC. No significant interobserver variability existed between the blinded assessments. Conclusions: MRI/MR angiography are accurate, fast, and safe in characterizing neurovascular contact (NVC) at the brainstem. The site of NVC and ipsilateral facial nerve indentation in NVC are significant determinants for the development of hemifacial spasm (HFS). The lack of bilateral NVC at the anterior aspect of the root exit zone of the facial nerve could explain in part the lack of bilateral symptoms. The development and severity of HFS are not associated with a specific blood vessel or multiple contact points in NVC.
Persistent Identifierhttp://hdl.handle.net/10722/162293
ISSN
2015 Impact Factor: 8.166
2015 SCImago Journal Rankings: 3.691
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorHo, SLen_US
dc.contributor.authorCheng, PWen_US
dc.contributor.authorWong, WCen_US
dc.contributor.authorChan, FLen_US
dc.contributor.authorLo, SKen_US
dc.contributor.authorLi, LSWen_US
dc.contributor.authorTsang, KLen_US
dc.contributor.authorLeong, LLYen_US
dc.date.accessioned2012-09-05T05:18:43Z-
dc.date.available2012-09-05T05:18:43Z-
dc.date.issued1999en_US
dc.identifier.citationNeurology, 1999, v. 53 n. 9, p. 2132-2139en_US
dc.identifier.issn0028-3878en_US
dc.identifier.urihttp://hdl.handle.net/10722/162293-
dc.description.abstractBackground: Neurovascular contact (NVC) with the root exit zone (REZ) of the ipsilateral facial nerve is associated with hemifacial spasm (HFS, but unresolved issues remain. Objectives: To 1) determine the frequency of symptomatic and nonsymptomatic NVC, 2) determine the features of NVC associated with HFS, and 3) correlate severity of HFS to these features. Methods: Two independent, blinded, prospective assessments of high-resolution MR and MR angiography (MRA) images were performed on Chinese cases (HFS: n = 44; age-matched control subjects: n = 20). Results: Over 88% of 44 symptomatic sides in patients with HFS had NVC of the ipsilateral facial nerve. At least 80% of symptomatic sides involved NVC at the anterior aspect of the REZ [REZ(ant.)]. Although NVC was observed in approximately half of nonsymptomatic sides, at least 70% of them were not at REZ(ant.). NVC at the cisternal and intracanalicular portions of the facial nerve were not associated with HFS. Half of our patients with HFS had bilateral NVC, but none had bilateral symptoms. Most of our MR/MRA images showed that the size and position of the arterial branches of the vertebrobasilar system were markedly asymmetric. Of patients with bilateral NVC, over 83% had asymmetric NVC sites. The anterior inferior cerebellar artery was the most common vessel involved in NVC, but was not significantly associated with HFS. Most of the NVC involved one vessel at one contact point with no indentation. The development of HFS was significantly associated with nerve indentation in NVC. The development and severity of HFS were not associated with multiple contact points in NVC. No significant interobserver variability existed between the blinded assessments. Conclusions: MRI/MR angiography are accurate, fast, and safe in characterizing neurovascular contact (NVC) at the brainstem. The site of NVC and ipsilateral facial nerve indentation in NVC are significant determinants for the development of hemifacial spasm (HFS). The lack of bilateral NVC at the anterior aspect of the root exit zone of the facial nerve could explain in part the lack of bilateral symptoms. The development and severity of HFS are not associated with a specific blood vessel or multiple contact points in NVC.en_US
dc.languageengen_US
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.neurology.orgen_US
dc.relation.ispartofNeurologyen_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 And Overen_US
dc.subject.meshBasilar Artery - Pathologyen_US
dc.subject.meshBrain Stem - Blood Supplyen_US
dc.subject.meshCerebellum - Blood Supplyen_US
dc.subject.meshDominance, Cerebral - Physiologyen_US
dc.subject.meshFacial Nerve - Pathology - Physiopathologyen_US
dc.subject.meshFacial Nerve Diseases - Diagnosis - Physiopathologyen_US
dc.subject.meshFemaleen_US
dc.subject.meshHemifacial Spasm - Diagnosis - Physiopathologyen_US
dc.subject.meshHumansen_US
dc.subject.meshImage Enhancementen_US
dc.subject.meshImage Processing, Computer-Assisteden_US
dc.subject.meshMagnetic Resonance Angiographyen_US
dc.subject.meshMagnetic Resonance Imagingen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshNerve Compression Syndromes - Diagnosis - Physiopathologyen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshSpinal Nerve Roots - Pathology - Physiopathologyen_US
dc.subject.meshVertebral Artery - Pathologyen_US
dc.titleA case-controlled MRI/MRA study of neurovascular contact in hemifacial spasmen_US
dc.typeArticleen_US
dc.identifier.emailHo, SL:slho@hku.hken_US
dc.identifier.authorityHo, SL=rp00240en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.pmid10599794-
dc.identifier.scopuseid_2-s2.0-0032762989en_US
dc.identifier.hkuros49905-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0032762989&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume53en_US
dc.identifier.issue9en_US
dc.identifier.spage2132en_US
dc.identifier.epage2139en_US
dc.identifier.isiWOS:000084255300040-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridHo, SL=25959633500en_US
dc.identifier.scopusauthoridCheng, PW=7401619084en_US
dc.identifier.scopusauthoridWong, WC=36847941500en_US
dc.identifier.scopusauthoridChan, FL=7202586444en_US
dc.identifier.scopusauthoridLo, SK=18735187400en_US
dc.identifier.scopusauthoridLi, LSW=7501450364en_US
dc.identifier.scopusauthoridTsang, KL=55040563000en_US
dc.identifier.scopusauthoridLeong, LLY=36853257600en_US

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