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Author ORCID Identifier

0009-0008-8742-4469

Corresponding Author

Meena Iyer

meena0327@gmail.com

Abstract

Dolichoectasia refers to the non-focal dilatation and tortuosity of arteries, primarily affecting the vertebral and basilar arteries due to severe tunica intima degeneration. It is associated with genetic predisposition and atherosclerosis, leading to vessel wall weakening. Patients may remain asymptomatic or develop neurological deficits due to mass effect. We report a case of a 60-year-old male presenting with hemifacial spasm secondary to vertebral artery dolichoectasia. Magnetic Resonance Angiography (MRA) revealed ectatic and tortuous basilar and vertebral arteries, with the left vertebral artery compressing the left facial nerve complex. Using Smoker’s criteria, a diagnosis of dolichoectasia was confirmed. Dolichoectasia-induced hemifacial spasm results from vascular compression and pulsatile irritation of the facial nerve. Besides neural compression, dolichoectasia also increases the risk of cerebral infarction. Treatment involves antiplatelet therapy to mitigate stroke risk, with microvascular decompression considered for symptomatic relief. This case highlights the importance of MRI in evaluating unexplained facial spasms, ensuring timely diagnosis and management to prevent long-term complications.

Publication Date

2025

Publisher

JSS Academy of Higher Education & Research

Conflict of Interest

No conflict of interest.

Keywords

Dolichoectasia, Facial Nerve, Hemifacial Spasm

Word Count

651

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

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