Brain surgery: This is a surgical video of microvascular decompression (MVD) of facial nerve and removing a large vertebral artery away from root exit zone of facial nerve and successfully treating a severe form of hemifacial spasm which had resulted in significant disability. Patient's symptoms completely resolved after the operation. Case presentation by Dr. Farhad Limonadi MD, director of neurosurgery at Eisenhower Medical Center. Edited by Camus Yu