Neurological Surgery

Cerebrovascular Resources and FAQs

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Do Botox injections really work for hemifacial spasm?

Temporarily, yes. An injection of botulinum toxin (Botox) causes a small, partial paralysis of the muscle and stops the spasm. The paralysis is temporary, so injections need to be repeated approximately every six months. See more about Diagnosing and Treating Hemifacial Spasm.

What causes hemifacial spasm?

Hemifacial spasm is caused by any one of a number of possible irritants to the seventh cranial nerve, but it’s most frequently caused by a small blood vessel (usually an artery) compressing the  facial nerve at the brainstem. Find out more about Hemifacial Spasm.

How did I get carotid occlusive disease?

Your arteries most likely became narrowed or blocked due to the buildup of atherosclerotic plaque in your blood vessels.  That plaque buildup often occurs as a result of high cholesterol, high blood pressure, heart disease, diabetes, smoking, or obesity. Carotid occlusive disease also has a family component, so having a family history of stroke increases your own risk of having carotid stenosis or carotid occlusion. Find out more about Carotid Occlusive Disease.

How is hemifacial spasm treated?

Microvascular decompression surgery for hemifacial spasmInjections of botulinum toxin (Botox) can provide temporary relief, but the permanent solution is usually microdecompression surgery. See more about Diagnosing and Treating Hemifacial Spasm.

What is pulsatile tinnitus?

This illustration shows bilateral venous sinus narrowing (red circles).
This illustration shows bilateral venous sinus narrowing (red circles). As a result of the bilateral narrowing, the blood flow from the brain to the neck is compromised, contributing to intracranial hypertension and the symptoms of pseudotumor cerebri.

Tinnitus, which is the perception of sound when no external sound is present, is a complex symptom rather than a syndrome or disease. (Read more about Pulsatile Tinnitus.)

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Why is a carotid blockage dangerous?

If an artery becomes completely blocked (which is called carotid occlusion) or if piece of the blockage breaks off and travels to a smaller vessel where it completely blocks blood flow, a part of the brain may be completely deprived of oxygen, leading to the destruction of brain tissue. This is what happens during the event we call a stroke, or a “brain attack.”  There are nearly half a million strokes each year in the United States, and it’s the third leading cause of death. Stroke claims 140,000 American lives a year — and half of those fatal strokes can be traced to carotid occlusion.

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