Successful surgical treatment of intractable hemifacial spasm: A case report and review of cerebellar hamartomas of the floor of the fourth ventricle

Joseph H. Miller, Michael J. Montalbano, Joel Raborn, Amber Gordon, Elias Rizk, R. Shane Tubbs, Hyunmi Kim, John C. Wellons

Research output: Contribution to journalReview article

2 Citations (Scopus)

Abstract

Introduction Hamartomas involving the floor of the fourth ventricle and cerebellum are rare, but can be associated with medically recalcitrant hemifacial spasm. These lesions present early in the neonatal or infantile period and respond well to surgical excision. Case Report A 3-month-old white male presented with recurrent left hemifacial spasm, left eye deviation, and absent movement of the extremities. The patient was found to have a left eccentric lesion in the floor of the fourth ventricle and cerebellum. The patient showed no improvement with medical therapy by 6 months of age. He was taken to the operating room for suboccipital craniotomy and removal of the posterior arch of C1 followed by intralesional recording of epileptogenic activity and gross total resection of the lesion. After histologic analysis, the lesion was determined to be ectopic cerebral tissue consistent with a hamartoma. Postoperative MRI showed complete removal of the lesion, and the patient exhibited complete remission of his hemifacial spasm and associated symptoms. Conclusions Hamartomas involving the floor of the fourth ventricle can present with hemifacial spasm and respond well to surgical excision.

Original languageEnglish (US)
Pages (from-to)1-4
Number of pages4
JournalTranslational Research in Anatomy
Volume5
DOIs
StatePublished - Dec 1 2016

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Hemifacial Spasm
Fourth Ventricle
Hamartoma
Cerebellum
Choristoma
Craniotomy
Operating Rooms
Therapeutics
Extremities

All Science Journal Classification (ASJC) codes

  • Anatomy

Cite this

Miller, Joseph H. ; Montalbano, Michael J. ; Raborn, Joel ; Gordon, Amber ; Rizk, Elias ; Tubbs, R. Shane ; Kim, Hyunmi ; Wellons, John C. / Successful surgical treatment of intractable hemifacial spasm : A case report and review of cerebellar hamartomas of the floor of the fourth ventricle. In: Translational Research in Anatomy. 2016 ; Vol. 5. pp. 1-4.
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abstract = "Introduction Hamartomas involving the floor of the fourth ventricle and cerebellum are rare, but can be associated with medically recalcitrant hemifacial spasm. These lesions present early in the neonatal or infantile period and respond well to surgical excision. Case Report A 3-month-old white male presented with recurrent left hemifacial spasm, left eye deviation, and absent movement of the extremities. The patient was found to have a left eccentric lesion in the floor of the fourth ventricle and cerebellum. The patient showed no improvement with medical therapy by 6 months of age. He was taken to the operating room for suboccipital craniotomy and removal of the posterior arch of C1 followed by intralesional recording of epileptogenic activity and gross total resection of the lesion. After histologic analysis, the lesion was determined to be ectopic cerebral tissue consistent with a hamartoma. Postoperative MRI showed complete removal of the lesion, and the patient exhibited complete remission of his hemifacial spasm and associated symptoms. Conclusions Hamartomas involving the floor of the fourth ventricle can present with hemifacial spasm and respond well to surgical excision.",
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Successful surgical treatment of intractable hemifacial spasm : A case report and review of cerebellar hamartomas of the floor of the fourth ventricle. / Miller, Joseph H.; Montalbano, Michael J.; Raborn, Joel; Gordon, Amber; Rizk, Elias; Tubbs, R. Shane; Kim, Hyunmi; Wellons, John C.

In: Translational Research in Anatomy, Vol. 5, 01.12.2016, p. 1-4.

Research output: Contribution to journalReview article

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AU - Miller, Joseph H.

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AU - Raborn, Joel

AU - Gordon, Amber

AU - Rizk, Elias

AU - Tubbs, R. Shane

AU - Kim, Hyunmi

AU - Wellons, John C.

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N2 - Introduction Hamartomas involving the floor of the fourth ventricle and cerebellum are rare, but can be associated with medically recalcitrant hemifacial spasm. These lesions present early in the neonatal or infantile period and respond well to surgical excision. Case Report A 3-month-old white male presented with recurrent left hemifacial spasm, left eye deviation, and absent movement of the extremities. The patient was found to have a left eccentric lesion in the floor of the fourth ventricle and cerebellum. The patient showed no improvement with medical therapy by 6 months of age. He was taken to the operating room for suboccipital craniotomy and removal of the posterior arch of C1 followed by intralesional recording of epileptogenic activity and gross total resection of the lesion. After histologic analysis, the lesion was determined to be ectopic cerebral tissue consistent with a hamartoma. Postoperative MRI showed complete removal of the lesion, and the patient exhibited complete remission of his hemifacial spasm and associated symptoms. Conclusions Hamartomas involving the floor of the fourth ventricle can present with hemifacial spasm and respond well to surgical excision.

AB - Introduction Hamartomas involving the floor of the fourth ventricle and cerebellum are rare, but can be associated with medically recalcitrant hemifacial spasm. These lesions present early in the neonatal or infantile period and respond well to surgical excision. Case Report A 3-month-old white male presented with recurrent left hemifacial spasm, left eye deviation, and absent movement of the extremities. The patient was found to have a left eccentric lesion in the floor of the fourth ventricle and cerebellum. The patient showed no improvement with medical therapy by 6 months of age. He was taken to the operating room for suboccipital craniotomy and removal of the posterior arch of C1 followed by intralesional recording of epileptogenic activity and gross total resection of the lesion. After histologic analysis, the lesion was determined to be ectopic cerebral tissue consistent with a hamartoma. Postoperative MRI showed complete removal of the lesion, and the patient exhibited complete remission of his hemifacial spasm and associated symptoms. Conclusions Hamartomas involving the floor of the fourth ventricle can present with hemifacial spasm and respond well to surgical excision.

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