Developmental venous anomaly causing trigeminal neuralgia

Acioly, Marcus André; Simões, Elington Lannes; Parise, Maud; Telles, Carlos; Nigri, Flavio

doi:10.1590/s0004-282x2010000500031

Cited by 10 publications

(8 citation statements)

References 12 publications

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“…Of the cases of TN caused by a DVA with sufficient treatment descriptions in the literature, 5 were treated conservatively, 1 underwent glycerol rhizotomy and 10 underwent MVD [2,15]. Table 1 summarizes these cases.…”

Section: Discussionmentioning

confidence: 99%

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Gamma Knife Stereotactic Radiosurgery for Trigeminal Neuralgia Caused by a Developmental Venous Anomaly

Harrison

Lunsford²,

Monaco³

2015

Stereotact Funct Neurosurg

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Background: Trigeminal neuralgia (TN) is mostly caused by vascular compression of the nerve's root entry zone due to an ectatic artery. Rarer causes include compression from tumors, vascular malformations or multiple sclerosis plaques. Developmental venous anomalies (DVAs) are benign, aberrantly appearing venous structures that drain normal cerebral tissue. DVAs are a rare etiology of TN. The management of TN caused by a DVA is controversial as disruption of the DVA can be catastrophic. Methods: We report a case of a young man with severe medically refractory TN related to a brachium pontis DVA who was successfully treated by gamma knife stereotactic radiosurgery (GKSR) to the trigeminal nerve. Results: Within 2 weeks of GKSR, the patient reported experiencing 60% pain relief; 5 years postoperatively, he remains completely pain free with some mild sensory loss in the V2 and V3 areas. Conclusions: GKSR has an established role in the management of TN. This is the first reported case of using GKSR to treat TN caused by a DVA. In the setting of a DVA, GKSR should be an initial consideration for TN therapy after medical failure because of the high surgical risk related to disrupting the DVA.

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Section: Discussionmentioning

confidence: 99%

“…To our knowledge, there appear to be only 20 total reported cases [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16]. Although microvascular decompression (MVD) is the favored surgical treatment of refractory TN, surgical disruption of a DVA can lead to severe neurological deficits or even death due to venous infarction [16].…”

Section: Introductionmentioning

confidence: 99%

Gamma Knife Stereotactic Radiosurgery for Trigeminal Neuralgia Caused by a Developmental Venous Anomaly

Harrison

Lunsford²,

Monaco³

2015

Stereotact Funct Neurosurg

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“…12 A longitudinal study by Naff et al showed that of 60 patients with DVAs, the prevalence of headache decreased from 53% (32/60) to 38% (23/60) over the mean follow-up of 4.2 years. [20][21][22] DVAs and seizures.-It is also debated whether or not isolated, uncomplicated DVAs predispose patients to developing seizures. Finally, there are cases of DVAs mimicking ophthalmoplegic migraine and migraine with ataxia, as well as DVAs causing trigeminal neuralgia.…”

Section: Expert Commentarymentioning

confidence: 99%

“…Finally, there are cases of DVAs mimicking ophthalmoplegic migraine and migraine with ataxia, as well as DVAs causing trigeminal neuralgia. [20][21][22] DVAs and seizures.-It is also debated whether or not isolated, uncomplicated DVAs predispose patients to developing seizures. In the Naff et al study, the seizure prevalence decreased with the length of follow-up time (from 32% at baseline to 20% at follow-up).…”

Section: Expert Commentarymentioning

confidence: 99%