The impact of perforating arterial branches on microvascular decompression for hemifacial spasm

The anatomical characteristics of perforating branches vary depending on the parent vessel. AICA perforators are usually shorter and more often supply the CN VII-VIII complex, thereby posing a greater challenge during MVD compared to PICA branches. Nonetheless, with appropriate surgical expertise, neuroendoscopic visualization, and adjunctive intraoperative monitoring, favorable outcomes can still be reliably achieved.