Magnetic resonance imaging of vertebrobasilar ectasia in tic convulsif. Case report

G. R. Harsh IV, C. B. Wilson, G. B. Hieshima, W. P. Dillon

Research output: Contribution to journalArticlepeer-review

41 Scopus citations

Abstract

A patient with trigeminal neuralgia and hemifacial spasm was evaluated using multiplanar magnetic resonance (MR) imaging with gadolinium enhancement. Preoperative images demonstrated massively ectatic vertebral and basilar arteries and their distortion of the brain stem and the trigeminal and facial nerves. Surgical manipulation included selective trigeminal rhizotomy, cushioning of the residual nerve at the point of maximal distortion by the underlying basilar artery, and microvascular decompression of the seventh nerve from the anterior inferior cerebellar artery which was being pushed dorsomedially by the vertebral artery. Postoperatively, the patient had neither trigeminal neuralgia nor facial spasm. Gadolinium-enhanced MR imaging not only excludes other etiologies such as tumor or arteriovenous malformation, but also demonstrates cranial nerve compression by ectatic vertebral and basilar arteries. The choice of preoperative imaging modality is discussed and the literature concerning the etiology of tic convulsif is reviewed.

Original languageEnglish (US)
Pages (from-to)999-1003
Number of pages5
JournalJournal of Neurosurgery
Volume74
Issue number6
DOIs
StatePublished - 1991
Externally publishedYes

Keywords

  • hemifacial spasm
  • magnetic resonance imaging
  • tic convulsif
  • trigeminal neuralgia

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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