neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"10.63769/1683-3295-2016-0-1-68-72neurosurgery-352Research ArticleНАБЛЮДЕНИЕ ИЗ ПРАКТИКИFROM PRACTICEПРИМЕНЕНИЕ МИКРОВАСКУЛЯРНОЙ ДЕКОМПРЕССИИ ПРИ СОЧЕТАНИИ ГЕМИФАЦИАЛЬНОГО СПАЗМА И ТРИГЕМИНАЛЬНОЙ НЕВРАЛГИИ: КЛИНИЧЕСКОЕ НАБЛЮДЕНИЕTHE USAGE OF MICRO-VASCULAR DECOMPRESSION IN CASE OF COMBINATION OF HEMIFACIAL SPASM AND TRIGEMINAL NEURALGIA: CASE REPORTРзаевД. А.RzaevD. A.

Рзаев Джамиль Афетович — кандидат медицинских наук, врач-нейрохирург, Главный врач ФГБУ ФЦН. 

Новосибирск.

d_rzaev@neuronsk.ruМойсакГ. И.MoisakG. I.

Мойсак Галина Ивановна — кандидат медицинских наук, врач-невролог ФГБУ ФЦН г. Новосибирск, ассистент кафедры фундаментальной медицины Новосибирского государственного университета. 

Новосибирск.

g_moysak@neuronsk.ruКуликоваЕ. В.KulikovaE. V.

Куликова Елена Викторовна — врач-нейрохирург ФГБУ ФЦН. 

Новосибирск.

e_kulikova@neuronsk.ruФГБУ Федеральный центр нейрохирургии.Russian FederationФГБУ Федеральный центр нейрохирургии; Новосибирский государственный университет.Russian Federation201606102017016872Copyright © Рзаев Д.А., Мойсак Г.И., Куликова Е.В., 20172017Рзаев Д.А., Мойсак Г.И., Куликова Е.В.Rzaev D.A., Moisak G.I., Kulikova E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/352

Особым вариантом нейроваскулярного конфликта является сочетанная компрессия тройничного и лицевого нервов у пациентов, страдающих «болезненным лицевым тиком». В статье представлено описание клинического наблюдения левосторонней тригеминальной невралгии, которая имела прогрессирующее фармакорезистентное течение и сочеталась с гемифациальным спазмом. При нейровизуализационном исследовании у пациентки выявлены МР-признаки нейроваскулярного конфликта между мегадолихобазилярис и V, VII левыми черепными нервами. С учетом этих данных больной провели микроваскулярную декомпрессию лицевого и тройничного нервов. В ходе оперативного вмешательства выявлен тесный контакт между корешками тройничного и лицевого нервов с петлей фузиформно расширенной смещенной влево долихобазилярис. В послеоперационном периоде достигнут полный регресс симптомов тригеминальной невралгии и гемифациального спазма. Наблюдение демонстрирует эффективность микроваскулярной декомпрессии в лечении сложного фармакорезистентного комбинированного заболевания, вызванного одним этиологическим фактором.

The specific variant of neurovascular conflict is the combination of trigeminal and facial nerves compression in patients suffered from «tic douloureux». This article presents the case report of left-sided progressive drug-resistant trigeminal neuralgia combined with hemifacial spasm. The MR-signs of neurovascular conflict between megadolichobasilar artery and roots of trigeminal and facial nerves were observed during examination of female patient. The microvascular decompression of trigeminal and facial nerves was performed. The close contact between roots of trigeminal and facial nerves and dolichobasilar loop dislocated to the left was revealed during operation. The full regress of symptoms of trigeminal neuralgia and hemifacial spasm was achieved in postoperative period. This clinical case demonstrates the efficacy of microvascular decompression for treatment of complex combined drug-resistant pathology because of one etiologic factor.

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The authors declare that there are no conflicts of interest present.