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Background: Microvascular decompression (MVD) has become widely accepted for hemifacial spasm (HFS). The significance of facial nerve notch (FNN) for the outcome after MVD is still unknown.Objective: To investigate the correlative analysis between the FNN at the root exit zone (REZ) and the curative effect of MVD for HFS.Method: A prospective study was performed, which included 232 patients with Cohen score ≥2 who had undergone MVD. The patients were divided into two groups: the group with facial nerve notch (FNN) and the group without FNN, according to whether there is FNN caused by the offending vessels during the MVD operation. All the patients were followed up for 24 months.Results: The group with FNN caused by offending vessels at the REZ area was confirmed in 119 patients, of which 117 patients were immediately cured and two patients received partial relief on the 1st day of postoperation. The group without FNN at the REZ area was confirmed in 113 patients, of which 43 patients were immediately completely cured while 70 patients were not immediately completely cured after MVD operation. After 24 months of follow-up, 119 patients with FNN were all completely cured, 71 patients without FNN were completely cured, and 42 patients without FNN were not completely cured. Multivariate logistic regression analysis shows that compared with without FNN group, the FNN group had statistical significance for the clinical results both on the-1st -day (P < 0.01) and 2 years of follow-up (P < 0.05) after MVD operation.Conclusions: FNN is an important reference factor to evaluate both the short-term and long-term curative effect of microvascular decompression for hemifacial spasm. The postoperative effect of patients with FNN is much better than that of patients without FNN. [ABSTRACT FROM AUTHOR]

Subject: To quantitatively describe the distance between the cranial nerve (CN) IX-X root entry/exit zone (REZ) and the pontomedullary sulcus in patients with hemifacial spasm (HFS). Methods: A total of 215 outpatients with HFS were recruited. Finally, 108 patients who yielded high-quality images were enrolled in the study. MRIs were reconstructed to measure the distance between the bilateral CN IX-X REZs and the corresponding pontomedullary sulcus. Results: Among the 108 patients, the ratio of males to females was 39/69, and the mean age was 57.9 ± 6.5 years. The ratio of left to right HFS involvement was 47/61. The average height was 1.62 ± 0.07 m, and the average body mass index (BMI) was 24.65 ± 2.97 kg/m2. The distance between the cephalic end of the CN IX-X REZ and the pontomedullary sulcus was 2.7 ± 0.9 mm. The distance between the caudal end of the CN IX-X REZ and the pontomedullary sulcus was 7.6 ± 1.1 mm. No monotonic relationship was found between distance and height or BMI in the scatter diagrams. Conclusions: The CN IX-X REZ is closely related to the pontomedullary sulcus in patients with HFS, and there is no difference between the left and right sides. The distances were not correlated with height or BMI in patients with HFS. [ABSTRACT FROM AUTHOR]

Epidemiological studies demonstrate that there are sex differences in the incidence, prevalence, and outcomes of cerebrovascular disease (CVD). The present study compared the structure and composition of the middle cerebral artery (MCA), neurovascular coupling, and cerebrovascular function and cognition in young Sprague-Dawley (SD) rats. Wall thickness and the inner diameter of the MCA were smaller in females than males. Female MCA exhibited less vascular smooth muscle cells (VSMCs), diminished contractile capability, and more collagen in the media, and a thicker internal elastic lamina with fewer fenestrae compared with males. Female MCA had elevated myogenic tone, lower distensibility, and higher wall stress. The stress/strain curves shifted to the left in female vessels compared with males. The MCA of females failed to constrict compared with a decrease of 15.5 ± 1.9% in males when perfusion pressure was increased from 40 to 180 mmHg. Cerebral blood flow (CBF) rose by 57.4 ± 4.4 and 30.1 ± 3.1% in females and males, respectively, when perfusion pressure increased from 100 to 180 mmHg. The removal of endothelia did not alter the myogenic response in both sexes. Functional hyperemia responses to whisker-barrel stimulation and cognition examined with an eight-arm water maze were similar in both sexes. These results demonstrate that there are intrinsic structural differences in the MCA between sexes, which are associated with diminished myogenic response and CBF autoregulation in females. The structural differences do not alter neurovascular coupling and cognition at a young age; however, they might play a role in the development of CVD after menopause. NEW & NOTEWORTHY Using perfusion fixation of the middle cerebral artery (MCA) in calcium-free solution at physiological pressure and systematically randomly sampling the sections prepared from the same M2 segments of MCA, we found that there are structural differences that are associated with altered cerebral blood flow (CBF) autoregulation but not neurovascular coupling and cognition in young, healthy Sprague-Dawley (SD) rats. Understanding the intrinsic differences in cerebrovascular structure and function in males and females is essential to develop new pharmaceutical treatments for cerebrovascular disease (CVD). [ABSTRACT FROM AUTHOR]