Coexistent Hemifacial Spasm and Trigeminal Neuralgia Secondary to Chiari'sⅠMalformation with Hydrocephalus: Case Report and Literature Review

【摘要】：OBJECTIVE: Chiari's Ⅰmalformation with hydrocephalus is commonly seen in clinical experience. Trigeminal neuralgia(TN) and hemifacial spasm(HFS) are most commonly related to vascular compression of the root entry/enter zoon(REZ). TN and HFS associated with hydrocephalus caused by Chiari's malformation are rare. We report a case of Chiari'sⅠmalformation with hydrocephalus only presenting as right coexistent TN and HFS. CLINICAL PRESENTATION: A 24-year-old male patient with HFS and ipsilateral TN affecting the maxillary and mandibular divisions of the trigeminal nerve was admitted. He had occasional headache. Arnold Chiari'sⅠmalformation and associated hydrocephalus were found in Magnetic resonance imaging of brain. He underwent a programmable ventriculoperitoneal shunt with complete resolution of all symptoms. CONCLUSIONS: Chiari's malformation with hydrocephalus presented with HFS and TN is not reported until now. In this case, Chiari's malformation caused obstructive hydrocephalus which is associated with intracranial hypertersion, and might lead to the compression of cranial nucli and stretching of cranial nerves(trigeminal and facial nerves), which resulted in his clinical symptoms of HFS and TN. The treatment of hydrocephalus alone resolved his symptoms.