Immediate disappearance of hemifacial spasm after partial removal of ponto-medullary junction anaplastic astrocytoma: case report

Neurosurg Rev. 2015 Apr;38(2):385-90; discussion 390. doi: 10.1007/s10143-014-0586-y. Epub 2014 Nov 11.


Hemifacial spasm (HFS) is generally caused by a neurovascular conflict (NC) at the root exit zone (REZ) of the facial nerve at the brainstem. Although a direct compression to the seventh cranial nerve (CN) by the anterior inferior cerebellar artery (AICA) is generally the most frequent cause, secondary HFS may be related to other pathological conditions. HFS due to an intracranial mass lesion is exceptionally rare and it has been reported in very few cases. The online database was searched for English-language articles reporting cases of HFS due to brainstem mass lesions and the possible pathophysiological mechanisms involved in its genesis. A 47-year-old man affected by an anaplastic astrocytoma of the brainstem at the level of the ponto-medullary junction developed right HFS. He underwent a subtotal surgical removal of the tumor with complete resolution of the HFS. This is the ninth reported case of HFS caused by an intrinsic brainstem tumor. The exceptional rarity of the relationship between intra-axial tumors and peripheral HFS was analyzed.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Astrocytoma / diagnosis
  • Astrocytoma / surgery*
  • Brain Stem Neoplasms / diagnosis
  • Brain Stem Neoplasms / surgery*
  • Facial Nerve Diseases / etiology*
  • Hemifacial Spasm / surgery*
  • Humans
  • Male
  • Middle Aged
  • Nerve Compression Syndromes / etiology