Facial hemispasm leading to the diagnosis of intracranial aneurysm: a case report
Author: Maria Silvia Burnier Ganimi Oliveira
Base Hospital / Institution: Hospital Evangélico de Belo Horizonte
ePoster presentation
Abstract ID: 24-467
Purpose
To report a severe neurological diagnosis of a non-ruptured anterior communicating artery aneurysm identified early through Oculoplastic evaluation due to hemifacial spasm and retro-orbital pain.
Methods
A 65-year-old woman with right hemifacial spasm and right retro-orbital pain for the past 6 months, history of smoking, diabetes and systemic arterial hypertension, sought ophthalmological care for evaluation of botulinum toxin application. The ophthalmic exam revealed: best-corrected visual acuity 20/70 in her right eye and 20/70 in her left eye, presence of right hemifacial spasm, dermatochalasis and hypofunction of the right lateral rectus. The slit-lamp biomicroscopy showed the presence of nuclear cataracts. Normal findings on fundus, tonometry and puppilary reflexes examinations. After evaluation a neurological etiology was suspected, she was referred with priority for further neurological and radiological investigation. Angiotomography and angioresonance revelead non-ruptured 8 milimeters anterior communicating artery saccular aneurysm. During the aneurysm clipping surgery, a second non-ruptured aneurysm at the bifurcation of the middle cerebral artery was also found and clipped. The patient progressed without associated neurological sequelae.
Results
Although the locations of the aneurysms are not often related with patient symptoms, at 12-month follow-up there were complete resolution of the hemifacial spasm and the retro-orbital pain. In addition the patient maintains a stable ophthalmic examination.
Conclusion
In the literature, there are few cases of patients presenting with spasms seeking ophthalmic evaluation and being diagnosed with severe conditions such as aneurysms. This emphasises the importance of ophthalmic examination and early complementary investigations.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Vanessa | Dib Salge | Hospital Evangélico de Belo Horizonte |
| Tassiana | Jeaninne Malagoli De Resende | Hospital Evangélico de Belo Horizonte |
| Valentina | Vallim Costa de Carvalho | Faculdade Ciências Médicas de Minas Gerais |
| Sandra Cristina | Vallim Costa de Carvalho | Centro Oftalmológico de Minas Gerais |
